ORIGINAL ARTICLES   

International Angiology 2002 September;21(3):237-43

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Variability of ankle-arm index in general population according to its mode of calculation

Aboyans V. ¹, Lacroix P. ¹, Preux P. M. ², Vergnenègre A. ², Ferrières J. ³, Laskar M. ¹

Departments of 1 Cardiovascular Surgery and Angiology, 2 Public Health, Dupuytren University Hospital, Limoges, 3 Inserm U518, Toulouse University School of Medicine, Toulouse, France

Background. Ankle-arm index (AAI) is com­mon­ly used in epi­dem­i­olog­i­cal stud­ies on periph­er­al arte­ri­al dis­ease but its mode of cal­cu­la­tion var­ies through­out the lit­er­a­ture. We aimed to study the var­i­ance of the dif­fer­ent meas­ure­ments ­required to cal­cu­late the AAI accord­ing to dif­fer­ent for­mu­las, in order to find out the best way of AAI cal­cu­la­tion, based on its less­er var­i­abil­ity.
Methods. A sam­ple of 222 sub­jects from the gen­er­al pop­u­la­tion was pros­pec­tive­ly stud­ied. Ten per­sons were exclud­ed ­because of the pres­ence of inter­mit­tent claud­i­ca­tion or due to a lack of a Doppler pos­te­ri­or tibi­al ­artery (PT) sig­nal. The sys­tol­ic pres­sures of both arms, the dor­sal­is pedis arter­ies (DP) and the PT were final­ly meas­ured in 212 ­healthy per­sons (mean age 49.9, range 18-101).
Results. Methods using the low­est ankle ­artery pres­sure were exclud­ed, as an ­absent pedal pulse may not be abnor­mal. The mode using the low­est var­i­ance was the ­choice of the high­est pres­sure ­between PT and DP of each leg divid­ed by the mean of the sys­tol­ic pres­sures of both arms.
Conclusions. We rec­om­mend this mode of AAI cal­cu­la­tion in epi­dem­i­olog­i­cal stud­ies. As the var­i­anc­es of the meas­ure­ments used are the low­est, it would be easi­er there­af­ter to deter­mine nor­mal rang­es and cut­off ­points.