Kidney Week

Abstract: FR-PO1045

The Ankle-Brachial Index Is Linked to the Subendocardial Viability Ratio: A Correlation Between Peripheral and Myocardial Perfusion

Session Information

• Hypertension and CVD: Clinical Outcomes, Trials
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

• Piko, Nejc, University Clinical Centre Maribor, Maribor, Slovenia

Nejc Piko,

• Hojs, Radovan, University Clinical Centre Maribor, Maribor, Slovenia

Radovan Hojs,

• Bevc, Sebastjan, University Clinical Centre Maribor, Maribor, Slovenia

Sebastjan Bevc,

• Vodošek Hojs, Nina, University Clinical Centre Maribor, Maribor, Slovenia

Nina Vodošek Hojs,

• Petreski, Tadej, University Clinical Centre Maribor, Maribor, Slovenia

Tadej Petreski,

• Ekart, Robert, University Clinical Centre Maribor, Maribor, Slovenia

Robert Ekart,

Background

Subendocardial viability ratio (SEVR), non-invasively calculated through pulse wave analysis (PWA), is an index of myocardial oxygen supply and demand. Lower SEVR values are linked with advanced coronary artery disease (CAD) and higher mortality, especially in patients with chronic kidney disease (CKD). Peripheral artery disease (PAD) can be assessed by the ankle-brachial index (ABI) and is also associated with increased cardiovascular mortality. Both PAD and CAD are the result of advanced athersclerosis and increased arterial stiffness, but the direct correlation between these two entities is still not fully understood. The aim of our study was to determine the correlation between PAD and CAD by using ABI and SEVR.

Methods

86 clinically stable patients with ishemic CAD (56 male, 65.1%), who were hospitalized due to elective coronary angiography, were included in the study. Kidney function was determined by the estimation of glomerular filtration rate (eGFR) using the CKD-EPI Creatinine equation. SEVR was determined with PWA (SphygmocorÒ, Atcor Medical, Australia) and ABI index was measured using an automated, non-invasive, waveform analysis device (MESIÒ, Slovenia). All the data were obtained prior to coronary angiography.

Results

Mean age of patients was 64.6±9.6 years (minimum 27, maximum 82 years). 23 patients had diabetes mellitus (26.7%) and 52 patients were smokers (60.5%). Mean eGFR was 74.5±18.4 ml/min/1.73 m². Mean ABI values were 1.0±0.1 (0.76-1.31), mean SEVR values were 163.1±34.7% (92-260%). Pearson's correlation test showed a statistically significant correlation between ABI and SEVR (r=0.251, p=0.02). Multiple regression analysis with SEVR as dependent variable has shown statistically significant association with ABI (p=0.032, beta coefficient=0.245) as independent variable, but not with age, diabetes, smoking, eGFR and cholesterol.

Conclusion

ABI is independently associated with SEVR in patients with stable CAD, suggesting a direct connection between peripheral and myocardial perfusion, independent of traditional atherosclerosis risk factors and kidney function.