Le Faucheur Alexis, Noury-Desvaux Bénédicte, Jaquinandi Vincent, Louis Saumet Jean, Abraham Pierre
Laboratory of Physiology, National Center for Scientific Research, University of Angers, Angers, France.
Med Sci Sports Exerc. 2006 Nov;38(11):1889-94. doi: 10.1249/01.mss.0000232021.21361.9c.
Exercise improves the diagnostic performance of ankle-to-brachial index (ABI) in the detection of exercise-induced arterial endofibrosis (EIAE). Pressure values for all four limbs are required to calculate ABI, but rapid systemic pressure changes occur during the recovery period from exercise. We checked whether after exercise, ABI calculated from simultaneous measurements was better than from consecutive measurements for differentiating athletes with EIAE from normal athletes.
We studied 42 normal athletes and 42 athletes suffering from unilateral pain caused by histologically proven EIAE. Bilateral brachial and ankle (ASBP) systolic blood pressure levels were simultaneously measured in the supine position at rest and every minute during the first 4 min of the recovery from incremental maximal exercise. Using receiver operating characteristics curves (ROC), we compared the diagnostic performance of single-leg ASBP and ABI values and between-leg ASBP (DeltaASBP) and ABI (DeltaABI) differences, calculated from simultaneous (simu) versus consecutive (cons) measurements, to discriminate athletes with EIAE from normal athletes.
For single-leg postexercise values, ROC curve area was significantly higher for ABIsimu compared with ASBPsimu (P < 0.05, r = 0.91) and ASBPrand (P < 0.05, r = 0.68). Areas (+/- SE of area) of the ROC curves for postexercise Delta ASBPsimu and Delta ABIsimu were 0.97 +/- 0.01 and 0.97 +/- 0.02, respectively, and were higher than areas for postexercise Delta ASBP and Delta ABI calculated from consecutive and random measurements (P < 0.01). Accuracy for postexercise Delta ASBPsimu and Delta ABIsimu in discriminating EIAE from normal athletes was 93% [95% CI; 85-97], with a cutoff point of 22 mm Hg and 0.10, respectively.
Delta ASBP and/or Delta ABI calculated from simultaneous pressure measurements should be recommended when searching for unilateral EIAE. Whether this result is applicable in the detection of early atherosclerotic lesions in sedentary subjects requires future investigation.
运动可提高踝臂指数（ABI）在检测运动诱发的动脉内膜纤维化（EIAE）中的诊断性能。计算ABI需要测量四肢的压力值，但在运动恢复期会出现快速的全身压力变化。我们研究了运动后，通过同步测量计算得到的ABI在区分患有EIAE的运动员与正常运动员方面是否优于连续测量得到的ABI。
我们研究了42名正常运动员和42名经组织学证实患有由EIAE引起的单侧疼痛的运动员。在静息仰卧位以及递增最大运动恢复的前4分钟内每分钟同步测量双侧肱动脉和踝部（ASBP）收缩压水平。使用受试者工作特征曲线（ROC），我们比较了通过同步（simu）与连续（cons）测量计算得到的单腿ASBP和ABI值以及两腿间ASBP（DeltaASBP）和ABI（DeltaABI）差值在区分患有EIAE的运动员与正常运动员方面的诊断性能。
对于单腿运动后值，与ASBPsimu（P < 0.05，r = 0.91）和ASBPrand（P < 0.05，r = 0.68）相比，ABIsimu的ROC曲线面积显著更高。运动后Delta ASBPsimu和Delta ABIsimu的ROC曲线面积（面积的±SE）分别为0.97±0.01和0.97±0.02，高于通过连续和随机测量计算得到的运动后Delta ASBP和Delta ABI的面积（P < 0.01）。运动后Delta ASBPsimu和Delta ABIsimu在区分EIAE与正常运动员方面的准确性为93%[95%CI；85 - 97]，截断点分别为22 mmHg和0.10。
在寻找单侧EIAE时，建议使用通过同步压力测量计算得到的Delta ASBP和/或Delta ABI。该结果是否适用于检测久坐人群的早期动脉粥样硬化病变有待进一步研究。
