Department of the Internal Medicine, Hypertension and Vascular Diseases, The Medical University of Warsaw, Warsaw, Poland.
Hypertens Res. 2013 Jan;36(1):25-8. doi: 10.1038/hr.2012.120. Epub 2012 Aug 9.
Automated oscillometric ankle-brachial index (ABI) devices were designed to measure ABI in a primary-care setting to increase the peripheral artery disease (PAD) detection rate. However, ABI measurements obtained with an automated oscillometric device may differ from those obtained using a standard ultrasound Doppler method in the general population. The purpose of this study was to compare PAD detection by the Doppler method and the automated WatchBP Office ABI system in a high-risk population with coronary artery disease (CAD). Eighty consecutive patients with confirmed CAD were included. ABI was measured by automated oscillometry followed by conventional Doppler evaluation. PAD was defined as an ABI≤0.9. Each lower extremity was analyzed separately. The Doppler method detected an ABI≤0.9 in 56 lower extremities, whereas the automated method detected an ABI≤0.9 in 28 lower extremities (P<0.0001). A Bland-Altman plot showed poor agreement between the two methods. The mean ABI values obtained by the automated and Doppler methods were significantly different (1.11±0.20 vs. 0.95±0.24; P<0.00001). The sensitivity of the automated ABI device in detecting an ABI≤0.9 was 46.3% and the specificity was 98.0%. The positive and negative predictive values for diagnosing an ABI≤0.9 using the automated oscillometric method were 92.8% and 76.9%, respectively. In conclusion, the automated WatchBP Office ABI system should be used with caution for PAD detection and screening in patients with CAD, and this system should not replace the Doppler method in populations at high risk of cardiovascular disease.
自动示波法踝臂指数（ABI）设备旨在测量初级保健环境中的 ABI，以提高外周动脉疾病（PAD）的检出率。然而，在普通人群中，使用自动示波设备测量的 ABI 可能与使用标准超声多普勒方法获得的 ABI 不同。本研究旨在比较多普勒方法和自动 WatchBP Office ABI 系统在冠心病（CAD）高危人群中的 PAD 检出率。连续纳入 80 例确诊 CAD 的患者。ABI 通过自动示波法测量，然后进行常规多普勒评估。PAD 的定义为 ABI≤0.9。每条下肢单独分析。多普勒方法检测到 56 条下肢 ABI≤0.9，而自动方法检测到 28 条下肢 ABI≤0.9（P<0.0001）。Bland-Altman 图显示两种方法之间的一致性较差。自动和多普勒方法获得的平均 ABI 值差异显著（1.11±0.20 vs. 0.95±0.24；P<0.00001）。自动 ABI 设备检测 ABI≤0.9 的灵敏度为 46.3%，特异性为 98.0%。使用自动示波法诊断 ABI≤0.9 的阳性预测值和阴性预测值分别为 92.8%和 76.9%。总之，在 CAD 患者中，应谨慎使用自动 WatchBP Office ABI 系统进行 PAD 检测和筛查，并且该系统不应替代心血管疾病高危人群中的多普勒方法。
