PMID- 31626931
OWN - NLM
STAT- MEDLINE
DCOM- 20200706
LR  - 20200706
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 63
DP  - 2020 Feb
TI  - Association Between Critical Limb Ischemia, the Society for Vascular Surgery 
      Wound, Ischemia and Foot Infection (WIfI) Classification System and Arterial 
      Stiffness.
PG  - 250-258.e2
LID - S0890-5096(19)30752-6 [pii]
LID - 10.1016/j.avsg.2019.07.017 [doi]
AB  - BACKGROUND: Arterial stiffness analysis has been done to classify cardiovascular 
      risk. The aim of this article is to analyze whether the group of patients with 
      chronic limb-threatening ischemia (CLTI) has higher arterial stiffness indices 
      than controls. The secondary objectives are to assess whether patients with 
      advanced stages of Wound, Ischemia, and foot Infection (WIfI) classification have 
      high levels of arterial stiffness, through multiple linear regressions to analyze 
      whether the ankle-brachial index (ABI) and other variables are predictive of 
      arterial stiffness. METHODS: We conducted a cross-sectional study with 66 
      patients with CLTI and 66 age- and sex-matched controls using brachial artery 
      oscillometry. Hemodynamic and arterial stiffness measurements, clinical 
      characteristics, laboratory data, and stages of WIfI classification were compared 
      between the groups CLTI and controls. Through multiple linear regression, we 
      identified predictors of pulse wave velocity (PWV) and augmentation index 
      normalized to 75 beats/min (AIx@75). RESULTS: Patients with CLTI had PWV 
      (11.8 +/- 1.6 m/sec vs. 10.0 +/- 1.8 m/sec, P < 0.01) and AIx@75 (29.2 +/- 9.8% 
      vs.18. +/- 10.35%, P < 0.01) higher than controls. In the multiple regression 
      model, there was influence of age (beta = 0.17, P < 0.01), antiplatelet therapy 
      (beta = -0.15, P = 0.04), peripheral systolic pressure (beta = 0.03, P < 0.01), and 
      clustered WIfI stages 3 and 4 (beta = 0.17, P = 0.02) of benefit of 
      revascularization on PWV. Multiple regression analysis identified diabetes 
      (beta = 7.51, P < 0.01) and the degree of ischemia measured by ABI (beta = -23.89, 
      P < 0.01) as predictors of elevated AIx@75. WIfI stages 3 and 4 of estimate risk 
      of amputation at 1 year predicts a high AIx@75 (beta = 9.77, P < 0.001) compared 
      with stages 1 and 2. CONCLUSIONS: The degree of ischemia in CLTI patients 
      determined by the ABI is associated with elevated arterial stiffness as measured 
      by the AIx@75. Advanced WIfI stages were predictors of elevated PWV and AIx@75.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Mendes-Pinto, Daniel
AU  - Mendes-Pinto D
AD  - Department of Vascular Surgery, Hospital Felicio Rocho, Belo Horizonte, MG, 
      Brazil; Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, MG, Brazil; 
      Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, 
      Brazil. Electronic address: daniel@vascularbh.com.br.
FAU - Rodrigues-Machado, Maria da Gloria
AU  - Rodrigues-Machado MDG
AD  - Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, MG, Brazil.
FAU - Navarro, Tulio Pinho
AU  - Navarro TP
AD  - Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, 
      Brazil.
FAU - Dardik, Alan
AU  - Dardik A
AD  - Department of Vascular Surgery, Yale University School of Medicine, New Haven CT, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20191015
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Ankle Brachial Index
MH  - Case-Control Studies
MH  - Critical Illness
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Ischemia/*diagnosis/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Peripheral Arterial Disease/*diagnosis/physiopathology
MH  - Predictive Value of Tests
MH  - Severity of Illness Index
MH  - *Vascular Stiffness
EDAT- 2019/10/19 06:00
MHDA- 2020/07/07 06:00
CRDT- 2019/10/19 06:00
PHST- 2019/06/06 00:00 [received]
PHST- 2019/07/25 00:00 [revised]
PHST- 2019/07/29 00:00 [accepted]
PHST- 2019/10/19 06:00 [pubmed]
PHST- 2020/07/07 06:00 [medline]
PHST- 2019/10/19 06:00 [entrez]
AID - S0890-5096(19)30752-6 [pii]
AID - 10.1016/j.avsg.2019.07.017 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2020 Feb;63:250-258.e2. doi: 10.1016/j.avsg.2019.07.017. Epub 2019 
      Oct 15.