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ABSTRACT
Objective: The purpose of the study was to compare the values of ankle brachial index (ABI) measured by Doppler and by sphygmomanometer.
Method: Thirty people were assessed for the ABI measurement through Doppler method by one investigator and by sphygmomanometer method done by another investigator.
Results: The correlation between the ABI taken with sphygmomanometer and with Doppler was 0.745. The value suggests positive correlation between the two. But kappa score was 0.267 with p value 0.143 implied that ABI measurement with Doppler could not be replaced with measurement with help of sphygmomanometer.
Conclusion: Best method of measuring ABI is with Doppler. ABI Measurement with sphygmomanometer does not give good result as compared to Doppler.
Keywords: Ankle Brachial Index (ABI), Doppler, Sphygmomanometer
INTRODUCTION
Peripheral arterial disease (PAD) is a chronic, lifestyle-limiting disease and is an independent predictor of cardiovascular and Cerebro-vascular accidents. Despite the recognition that PAD is associated with a marked increase in the risk of ischemic events, this particular manifestation of systemic atherosclerosis is largely under diagnosed and under treated.1 Peripheral Vascular Disease(PVD) is frequently asymptomatic in people with diabetes and may present with ischemic foot ulceration or gangrene with no previous claudication. Distal disease may allow reasonable blood supply to be maintained to the large muscles involved in walking while critically impairing the supply to the skin of feet. Co existent neuropathy and exercise limitation due to other diseases may also mask the symptoms of PVD.
Hence, regular screening physical examination is necessary to identify people with PVD.2 Palpation of peripheral pulsations and measuring Ankle Brachial Index (ABI) helps in assessment of vascular supply.2 The ankle-brachial index is the first-line test for both screening for peripheral artery disease and for diagnosing it. It is inexpensive and noninvasive to obtain and has a high sensitivity (79% to 95%) and specificity (95% to 96%) compared with angiography as the gold standard.3'7
Normally, systolic blood pressure in legs and arms is similar.8 In the presence of hemodynamically significant arterial stenosis, the systolic blood pressure in the leg is decreased.8 Thus, if one were to obtain a ratio of the ankle and brachial artery pressures, termed as Ankle Brachial Index or ABI, it would be 1.0 in normal individuals and < 1.0 in patients...