1. Exercise testing criteria to diagnose lower extremity peripheral artery disease assessed by computed-tomography angiography
- Author
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O Stivalet, A Paisant, D Belabbas, L Omarjee, A Le Faucheur, P Landreau, R Garlantezec, V Jaquinandi, D A Liedl, P W Wennberg, G Mahé, Unité de Médecine Vasculaire [Rennes], Centre Hospitalier Universitaire de Rennes (CHU Rennes), Service de Médecine Vasculaire [Saint Malo], CH de Saint-Malo, Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], CHU Pontchaillou [Rennes], Unité de Médecine Vasculaire [Redon], Centre Hospitalier de Redon (CH Redon), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), École normale supérieure - Cachan, antenne de Bretagne (ENS Cachan Bretagne), École normale supérieure - Cachan (ENS Cachan), Gonda Vascular Center [Rochester, MN, États-Unis], Mayo Clinic [Rochester], Bodescot, Myriam, and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Male ,Computed Tomography Angiography ,Blood Pressure ,Pathology and Laboratory Medicine ,Vascular Medicine ,Medicine and Health Sciences ,Public and Occupational Health ,Prospective Studies ,Musculoskeletal System ,ComputingMilieux_MISCELLANEOUS ,Stenosis ,Arteries ,Middle Aged ,Sports Science ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Chemistry ,Lower Extremity ,Physical Sciences ,Medicine ,Legs ,Female ,Anatomy ,Research Article ,Chemical Elements ,Science ,Sensitivity and Specificity ,Peripheral Arterial Disease ,Signs and Symptoms ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Diagnostic Medicine ,Humans ,Ankle Brachial Index ,Sports and Exercise Medicine ,Exercise ,Aged ,Ankles ,Biology and Life Sciences ,Physical Activity ,Femoral Arteries ,body regions ,Oxygen ,ROC Curve ,Physical Fitness ,Body Limbs ,Exercise Test ,Cardiovascular Anatomy ,Blood Vessels ,Blood Gas Monitoring, Transcutaneous - Abstract
BACKGROUND:The sensitivity and specificity of exercise testing have never been studied simultaneously against an objective quantification of arterial stenosis. Aims were to define the sensitivity and specificity of several exercise tests to detect peripheral artery disease (PAD), and to assess whether or not defined criteria defined in patients suspected of having a PAD show a difference dependent on the resting ABI. METHODS:In this prospective study, consecutive patients with exertional limb pain referred to our vascular center were included. All patients had an ABI, a treadmill exercise-oximetry test, a second treadmill test (both 10% slope; 3.2km/h speed) with post-exercise pressures, and a computed-tomography-angiography (CTA). The receiver-operating-characteristic curve was used to define a cut-off point corresponding to the best area under the curve (AUC; [CI95%]) to detect arterial stenosis ≥50% as determined by the CTA. RESULTS:Sixty-three patients (61+/-11 years-old) were included. Similar AUCs from 0.72[0.63-0.79] to 0.83[0.75-0.89] were found for the different tests in the overall population. To detect arterial stenosis ≥50%, cut-off values of ABI, post-exercise ABI, post-exercise ABI decrease, post-exercise ankle pressure decrease, and distal delta from rest oxygen pressure (DROP) index were ≤0.91, ≤0.52, ≥43%, ≥20mmHg and ≤-15mmHg, respectively (p0.91, cut-off values of post-exercise ABI decrease (AUC = 0.67[0.53-0.78]), and DROP (AUC = 0.67[0.53-0.78]) were ≥18.5%, and ≤-15mmHg respectively (p
- Published
- 2019
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