ArticleJournal of clinical hypertension (Greenwich, Conn.)2025
Effectiveness of Four-Limb Blood Pressure in Distinguishing Between Aortic Stenosis and Bilateral Lower-Extremity Arterial Stenosis.
Article in Journal of clinical hypertension (Greenwich, Conn.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Effectiveness of Four-Limb Blood Pressure in Distinguishing Between Aortic Stenosis and Bilateral Lower-Extremity Arterial Stenosis.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
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5 authors.
Funding
Abstract
In this study, we investigated the applicability of the ankle-brachial index (ABI) and brachial-ankle index (BAI) in distinguishing aortic stenosis (AS) from lower-extremity arterial stenosis. The difference between the ABI on both sides (∆ABI) was defined as the absolute value of the left ABI minus the right ABI. Lower BAI (L-BAI) was defined as the value of the side with the lowest BAI. We obtained four-limb blood pressure measurement data from 6435 patients. AS and bilateral lower-extremity arterial stenosis (BLEAS) were diagnosed. The performance of combined bilateral ABI decline, ΔABI, and L-BAI in diagnosing AS was evaluated. The control group showed normal bilateral ABI values, whereas the AS and BLEAS groups exhibited a bilateral ABI decline. The BLEAS group had the highest ∆ABI compared to the other groups. L-BAI in the BLEAS and AS groups was higher than that in the control group. AS screening using bilateral ABI ≤0.90 combined with ΔABI ≤0.10 and L-BAI >1.00 yielded an area under the receiver operating characteristic curve of 0.873 and a Youden index, sensitivity, and specificity of 0.724, 85.2%, and 87.2%, respectively. Validation in 1004 patients revealed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 90.0%, 96.0%, 54.2%, 99.5%, and 95.7%, respectively. In conclusion, combining bilateral ABI ≤0.90, ∆ABI ≤0.10, and L-BAI >1.00 can effectively screen for AS; this is useful in distinguishing AS from BLEAS, especially in cases of bilateral decline in lower-extremity ABI values.
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