Borderline Ankle-Brachial Index Value of 0.91–0.99 Is Associated With Endothelial Dysfunction

Masato Kajikawa; Tatsuya Maruhashi; Yumiko Iwamoto; Akimichi Iwamoto; Takeshi Matsumoto; Takayuki Hidaka; Yasuki Kihara; Kazuaki Chayama; Ayumu Nakashima; Chikara Goto; Kensuke Noma; Yukihito Higashi

doi:10.1253/circj.CJ-14-0165

Peripheral Vascular Disease

Borderline Ankle-Brachial Index Value of 0.91–0.99 Is Associated With Endothelial Dysfunction

Masato Kajikawa, Tatsuya Maruhashi, Yumiko Iwamoto, Akimichi Iwamoto, Takeshi Matsumoto, Takayuki Hidaka, Yasuki Kihara, Kazuaki Chayama, Ayumu Nakashima, Chikara Goto, Kensuke Noma, Yukihito Higashi

Author information

Masato Kajikawa
Department of Cardiovascular Medicine, Institute of Biomedical & Health Sciences
Tatsuya Maruhashi
Department of Cardiovascular Medicine, Institute of Biomedical & Health Sciences
Yumiko Iwamoto
Department of Cardiovascular Medicine, Institute of Biomedical & Health Sciences
Akimichi Iwamoto
Department of Cardiovascular Medicine, Institute of Biomedical & Health Sciences
Takeshi Matsumoto
Department of Cardiovascular Medicine, Institute of Biomedical & Health Sciences
Takayuki Hidaka
Department of Cardiovascular Medicine, Institute of Biomedical & Health Sciences
Yasuki Kihara
Department of Cardiovascular Medicine, Institute of Biomedical & Health Sciences
Kazuaki Chayama
Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical & Health Sciences
Ayumu Nakashima
Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital
Chikara Goto
Hiroshima International University
Kensuke Noma
Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University
Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital
Yukihito Higashi
Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University
Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital

Keywords: Ankle-brachial index, Endothelial function, Intima-media thickness, Peripheral artery disease, Vascular smooth muscle function

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Supplementary material

2014 Volume 78 Issue 7 Pages 1740-1745

DOI https://doi.org/10.1253/circj.CJ-14-0165

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Abstract

Background: An ankle-brachial index (ABI) value of 0.91–0.99 is considered borderline and associated with an increased risk of cardiovascular events. However, there is no information on the relationship between borderline ABI and endothelial function. Methods and Results: We measured ABI and assessed vascular function by flow-mediated vasodilation (FMD) and nitroglycerin-induced vasodilation in 389 subjects who underwent health examinations. Subjects were divided into 3 groups according to ABI (normal group: 1.00–1.40, borderline group: 0.91–0.99, abnormal group: ≤0.90 or >1.40). FMD was significantly smaller in both the borderline and the abnormal group than in the normal group. There was no significant difference in the vascular responses to nitroglycerin between the normal and borderline groups. Vascular response to nitroglycerin was significantly higher in the normal group than in the abnormal group. Borderline and abnormal ABI values were significantly associated with an increased odds ratio of low tertile of FMD levels, using the normal ABI group as the reference. Multiple logistic regression analysis for FMD revealed that age, sex, hypertension, diabetes mellitus, and borderline ABI independently remained associated with FMD. Conclusions: ABI of 0.91–0.99 is associated with endothelial dysfunction. ABI examination is a simple and cost-effective method for obtaining the additional information on the initial step of atherosclerosis beyond the assessment of peripheral artery disease. (Circ J 2014; 78: 1740–1745)

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