Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland.
Hypertens Res. 2018 Jan;41(1):60-65. doi: 10.1038/hr.2017.89. Epub 2017 Nov 2.
Atrial fibrillation may affect blood pressure measurements. The ankle-brachial index (ABI) is a ratio of systolic blood pressure measured on the lower and upper limbs that may also be affected by arrhythmia. The purpose of the study was to investigate whether atrial fibrillation influenced ABI results. Ninety-nine patients (age 66.6±11 years, 63 males and 36 females) who underwent electrical cardioversion of atrial fibrillation were investigated. ABI measurements using the Doppler method were performed on both lower extremities before and after electrical cardioversion. Measurements were repeated three times and then averaged. The ABI using both lower limbs was lower before electrical cardioversion than after restoration to sinus rhythm (right side: 1.132 (1.065-1.210) during atrial fibrillation vs. 1.179 (1.080-1.242) in sinus rhythm, P=0.019; left side: 1.142 (1.075-1.222) during atrial fibrillation vs. 1.170 (1.098-1.255) in sinus rhythm, P=0.011). However, the upper 95% confidence interval (CI) margins for the median differences in ABI were 0.045 and 0.040 for right and left, respectively, suggesting that the observed difference was clinically insignificant. There was a significant correlation between measurements obtained before and after electrical cardioversion on both lower limbs (r=0.61, P<0.001 and r=0.67, P<0.001). The Bland-Altman plot showed good agreement between measurements performed using the Doppler method during atrial fibrillation and sinus rhythm. Study results showed that atrial fibrillation did not have a clinically important effect on ABI measurements.
心房颤动可能会影响血压测量。踝臂指数（ABI）是测量四肢收缩压的比值，也可能受到心律失常的影响。本研究旨在探讨心房颤动是否会影响 ABI 结果。研究共纳入 99 例（年龄 66.6±11 岁，63 例男性，36 例女性）接受电复律治疗的心房颤动患者。使用多普勒法测量双侧下肢的 ABI，在电复律前后进行测量。测量重复 3 次，然后取平均值。电复律后恢复窦性心律时，双侧下肢的 ABI 均低于心房颤动时（右侧：心房颤动时为 1.132（1.065-1.210），窦性心律时为 1.179（1.080-1.242），P=0.019；左侧：心房颤动时为 1.142（1.075-1.222），窦性心律时为 1.170（1.098-1.255），P=0.011）。然而，ABI 中位数差值的上 95%置信区间（CI）上限分别为右侧 0.045 和左侧 0.040，表明观察到的差异在临床上无显著意义。双侧下肢电复律前后的测量值之间存在显著相关性（r=0.61，P<0.001 和 r=0.67，P<0.001）。Bland-Altman 图显示在心房颤动和窦性心律期间使用多普勒法进行的测量之间具有良好的一致性。研究结果表明，心房颤动对 ABI 测量无临床重要影响。
