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You are here: Contents > 2015 > Volume 24 Number 2 March 2015 > AORTIC VALVE DISEASE > Clinical Value of Ankle-Brachial Index in Asymptomatic Aortic Stenosis Patients

Clinical Value of Ankle-Brachial Index in Asymptomatic Aortic Stenosis Patients

Miquel Gomez1,2, Cristina Roqueta2,3, Lluis Molina1,2, Mercedes Cladellas1,2, Mireia Ble1,2, Josep Comin-Colet1,2, Cristina Soler1, Jordi Bruguera1,2

1Cardiology Department, Heart Diseases Biomedical Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, 2Department of Medicine, Universitat Autonoma de Barcelona, 3Geriatrics Department, Centre Forum-Parc de Salut Mar, Barcelona, Spain

Background and aim of the study: The study aim was to assess the prevalence and clinical value of the pathological ankle-brachial index (ABI) in asymptomatic aortic stenosis (AS) patients.

Methods: This prospective study included 203 asymptomatic AS patients, with a mean follow up of 18 ± 10.6 months. Six-minute walk tests (6MWT) and ABI measurements were performed when patients were included in the study. Study events were defined as death, hospital admission due to related symptoms, or a need for surgery.

Results: A total of 198 patients (95 females, 103 males; mean age 74.6 ± 9.5 years) completed the study. An abnormal ABI was found in 35.8%. Mean (± SD) values were: peak velocity Vmax 4.1 ± 0.8 m/s; maximum/mean


gradient 70.5 ± 25.1/43.3 ± 16.3 mmHg; aortic valve area 0.8 ± 0.7 cm2; indexed aortic valve area 0.4 ± 0.1 cm2/m2. A pathological ABI was associated with diabetes (p = 0.01), previous peripheral vascular disease (p = 0.04) and previous stroke (p = 0.04). In multivariate analyses, diabetes was an independent factor related to pathological ABI (relative risk 1.71, 95% CI 1.22-2.19). Patients with a pathological ABI walked less in the 6MWT (263.9 m versus 328.3; p = 0.002), but did not present a worse prognosis at follow up (p = NS). Conclusion: Among asymptomatic AS patients, 35.8% had an abnormal ABI and this was related to previous diabetes. These patients walked less in the 6MWT but did not have a worse prognosis at follow up.

The Journal of Heart Valve Disease 2015;24:164-168

Clinical Value of Ankle-Brachial Index in Asymptomatic Aortic Stenosis Patients

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