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2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)

2018; Elsevier BV; Volume: 71; Issue: 2 Linguagem: Inglês

10.1016/j.rec.2017.12.014

1885-5857

Jean‐Baptiste Ricco, Marie-Louise Bartelink, Martin Björck, Marianne Brodmann, Tina Cohnert, Martin Czerny, Marco De Carlo, Sebastian Debus, Christine Espinola‐Klein, Thomas Kahan, Serge Kownator, Lucia Mazzolai, A.R. Naylor, Joachim Röther, Muriel Sprynger, Michał Tendera, Gunnar Tepe, Maarit Venermo, Charalambos Vlachopoulos, Iléana Desormais, Petr Widimský, Philippe Kolh, Gert de Borst, Florian Dick, Çetin Erol, Marc Ferrini, Stavros K. Kakkos, Jes S. Lindholt, Heinrich P. Mattle, Piotr Pieniążek, Dierk Scheinert, Horst Sievert, Jakub Sulženko, Juan Tamargo, Lale Tokgözoğlu, Adam Torbicki, Nikolaos Tsakountakis, José Tuñón, Melina Vega de Céniga, Stephan Windecker, Victor Aboyans, Stefan Agewall, Emanuele Barbato, Héctor Bueno, António Coca, Jean-Philippe Collet, Ioan Mircea Coman, Verónica Dean, Victoria Delgado, Donna Fitzsimons, Oliver Gaemperli, Gerhard Hindricks, Bernard Iung, Peter Jüni, Hugo A. Katus, Juhani Knuuti, Patrizio Lancellotti, Christophe Leclercq, Theresa A. McDonagh, Massimo Piepoli, Piotr Ponikowski, Dimitrios Richter, Marco Roffi, Е. V. Shlyakhto, Iain Simpson, José Luis Zamorano, Parounak Zelveian, Markus Haumer, Dzmitry Isachkin, Tine De Backer, Mirza Dilić, Ivo Petrov, Majda Vrkić Kirhmajer, Debora Karetová, Eva Prescott, Hamdy Soliman, Ants Paapstel, Kimmo Mäkinen, Slavco Tosev, E. Messas, Zurab Pagava, Oliver Müller, Katerina Κ. Naka, Zoltán Járai, Þórarinn Guðjónsson, Michael Jonas, Salvatore Novo, Pranvera Ibrahimi, Olga Lunegova, Vilnis Dzerve, Nerijus Misonis, Jean Beissel, Elton Pllaha, Mustapha Taberkant, Torbjørn Bakken, Rui Campante Teles, Daniel Lighezan, А. О. Конради, Marco Zavatta, Juraj Maďarič, Zlatko Fras, Lorenzo Silva Melchor, Ulf Näslund, Beatrice Amann‐Vesti, Agu Obiekezie,

Complex Systems and Time Series Analysis

The ankle-brachial index (ABI) test is a common tool used for screening peripheral arterial disease (PAD), but its accuracy has been doubted especially in patients with incompressible arteries attributed to calcification. Advanced wearable sensing technologies have potential to offer novel solutions for PAD assessment. This study investigated several novel indicators using the Detrended Fluctuation Analysis (DFA) on beat-to-beat RR interval (RRI) and pulse arrival time (PAT) from the four limbs of 7 young healthy and 7 elderly PAD subjects in supine and sitting postures. The auxiliary value of these indicators in addition to ABI for PAD assessment was also studied using a binary logistic regression model. The results showed that the short-scale DFA coefficients (α1) of RRI, α1 of PATs of fingers and α1_ratio of PAT (the ratio of α1 of PAT between the ipsilateral finger and toe) in supine posture, were significantly different between the PAD and healthy groups (1.26 ± 0.24 vs 0.76 ± 0.21, 1.03 ± 0.30 vs 0.68 ± 0.19, and 0.84 ± 0.20 vs 1.42 ± 0.47, respectively, p < 0.05), and the α1 of RRI and α1_ratio of PAT were not significantly influenced by postural change. Moreover, using ABI together with the supine α1_ratio of PAT was more sensitive in detecting PAD (sensitivity = 92.9%) than ABI alone (78.6%) with the same specificity of 100%. The short-scale DFA coefficients of multi-site PAT in supine posture, which can be measured by wearable devices, is an auxiliary to ABI for detecting PAD.