Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile
Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile
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DOI：
10.1038/hr.2011.53
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发表时间：
2011-07-01
影响因子：
5.4
通讯作者：
Stergiou, George S.
中科院分区：
文献类型：
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作者：
Kollias, Anastasios;Xilomenos, Apostolos;Stergiou, George S.
踝臂指数（ABI）是广泛用于外周动脉疾病（PAD）诊断和心血管风险预测的方法。这项研究验证了使用示波血压 (BP) 监测仪进行的自动 ABI 测量，允许同时测量手臂和腿部血压。共有 93 名患者（高血压 83%；血脂异常 72%；糖尿病 45%；心血管疾病 23%；吸烟 15%）接受了多普勒和自动 ABI 测量，使用专业示波血压监测仪（Microlife WatchBP Office；三次同步臂腿血压测量）以随机顺序进行。多普勒读数 (1.08 +/- 0.17) 和 (1) 第一个示波 ABI 读数之间的平均差异为 0.03 +/- 0.11，(2) 两个示波读数的平均值为 0.02 +/- 0.10，(3) 三个示波读数的平均值为 0.02 +/- 0.09（全部 P < 0.01）。示波和多普勒 ABI 之间存在很强的相关性（对于单个示波读数和两个和三个示波读数的平均值，r 分别为 0.80、0.85 和 0.86；全部 P < 0.001）。 95% 的病例中，示波法与多普勒 ABI 诊断 PAD 的一致性（多普勒 ABI < 0.9）（kappa 0.79；糖尿病患者的一致性：94%，kappa 0.79）。受试者工作特征 (ROC) 曲线显示曲线下面积为 0.98，示波 ABI 截止值为 0.97，可实现诊断 PAD 的最佳灵敏度 (92%) 和特异性 (92%)。自动 ABI 测量的平均时间为 5.8 分钟，而多普勒测量的平均时间为 9.3 分钟 (P < 0.001)。多普勒和示波 ABI 通过相同的心血管危险因素（脉压、吸烟和心血管疾病史）进行关联和预测（多元回归分析）。使用专业血压监测仪进行自动 ABI 测量，允许同时进行臂腿血压测量，这似乎是多普勒测量的可靠且更快的替代方案。高血压研究 (2011) 34, 825-830; doi：10.1038/hr.2011.53； 2011 年 5 月 19 日在线发布
The ankle-brachial index (ABI) is a method used widely for peripheral arterial disease (PAD) diagnosis and cardiovascular risk prediction. This study validated automated ABI measurements taken using an oscillometric blood pressure (BP) monitor allowing simultaneous arm-leg BP measurements. A total of 93 patients (hypertension 83%; dyslipidemia 72%; diabetes 45%; cardiovascular disease 23%; smoking 15%) were submitted to Doppler and automated ABI measurements, performed using a professional oscillometric BP monitor (Microlife WatchBP Office; triplicate simultaneous arm-leg BP measurements), in a randomized order. The mean difference between the Doppler reading (1.08 +/- 0.17) and (1) the first oscillometric ABI reading was 0.03 +/- 0.11, (2) the average of two oscillometric readings was 0.02 +/- 0.10 and (3) the average of three oscillometric readings was 0.02 +/- 0.09 (P < 0.01 for all). Strong correlations were found between oscillometric and Doppler ABI (r 0.80, 0.85 and 0.86 for single and average of two and three oscillometric readings, respectively; P < 0.001 for all). Agreement between oscillometric and Doppler ABI in diagnosing PAD (Doppler ABI < 0.9) was found in 95% of cases (kappa 0.79; agreement in diabetics: 94%, kappa 0.79). A receiver operating characteristic (ROC) curve revealed area under the curve at 0.98, with a 0.97 oscillometric ABI cutoff for optimal sensitivity (92%) and specificity (92%) in diagnosing PAD. Average time for automated ABI measurement was 5.8 vs. 9.3 min for Doppler (P < 0.001). Doppler and oscillometric ABI were associated and predicted (multivariate regression analysis) by the same cardiovascular risk factors (pulse pressure, smoking and cardiovascular disease history). Automated ABI measurement using a professional BP monitor allowing simultaneous arm-leg BP measurements appears to be a reliable and faster alternative to Doppler measurement. Hypertension Research (2011) 34, 825-830; doi:10.1038/hr.2011.53; published online 19 May 2011