# Pedal acceleration time is related to arterial stiffness in patients with chronic limb-threatening ischemia

## TL;DR

This study finds that pedal acceleration time is correlated with arterial stiffness in patients with chronic limb-threatening ischemia, suggesting it could be a useful indicator for assessing limb ischemia.

## Contribution

The paper establishes a novel correlation between pedal acceleration time and arterial stiffness indexes in patients with chronic limb-threatening ischemia.

## Key findings

- Pedal acceleration time is positively correlated with pulse wave velocity (Spearman r = 0.69, p < 0.001).
- Pedal acceleration time is positively correlated with augmentation index corrected for heart rate (Spearman r = 0.59, p < 0.001).
- Pedal acceleration time has an inverse relationship with the ankle/brachial index (Spearman r = -0.79, p < 0.001).

## Abstract

Pedal acceleration time (PAT) is a novel indicator of peripheral arterial disease in the lower limbs. Elevated PAT values are associated with worse limb ischemia. Arterial stiffness indexes are another class of indicators recently studied in patients with chronic limb-threatening ischemia (CLTI). The correlation between PAT and arterial stiffness has not yet been established.

To analyze correlations between PAT and arterial stiffness indexes in patients with CLTI.

A cross-sectional analysis was conducted of patients with CLTI from August to December of 2022. The PAT measurements were performed using a vascular ultrasound machine and stiffness indexes were measured using a brachial artery oscillometry unit. An analysis was conducted of the correlations between central blood pressure, peripheral blood pressure, arterial stiffness, and PAT.

A total of 55 patients were analyzed, of whom 23 were women and 83.6% had diabetes. Mean PAT was 166.6 ms; mean pulse wave velocity (PWV) was 11.8 m/s, and the mean augmentation index corrected for a heart rate of 75 beats per minute (AIx@75) was 29.8%. There were positive correlations between PAT and PWV (Spearman r = 0.69; p < 0.001) and between PAT and AIx@75 (Spearman r = 0.59, p < 0.001) and an inverse relationship with the ankle/brachial index (Spearman r = -0.79; p < 0.001).

There is a correlation between arterial stiffness indexes and PAT in patients with CLTI. These indicators are important for quantification of limb ischemia.

O tempo de aceleração plantar (TAP) é um novo indicador da doença arterial periférica de membros inferiores. Valores elevados do TAP estão associados a pior isquemia do membro. Os índices de rigidez arterial são também indicadores recentemente estudados em pacientes com isquemia crônica ameaçadora ao membro (chronic limb-threatening ischemia, CLTI). A correlação entre o TAP e a rigidez arterial ainda não foi estabelecida.

Analisar a correlação entre TAP e índices de rigidez arterial em pacientes com CLTI.

Foi realizada a análise transversal de pacientes com CLTI entre agosto e dezembro de 2022. A medida do TAP foi feita utilizando aparelho de ultrassom vascular, e a medida dos índices de rigidez, utilizando aparelho de oscilometria da artéria braquial. Foi feita uma análise de correlação entre índices de pressão arterial central, pressão arterial periférica, de rigidez arterial e o TAP.

Foram analisados 55 pacientes, sendo 23 mulheres e 83,6% diabéticos. O TAP médio foi de 166,6 ms; a velocidade de onda de pulso (VOP) média foi de 11,8 m/s; e o índice de aumento médio corrigido para frequência cardíaca de 75 batimentos por minuto (AIx@75) foi de 29,8%. Houve correlação positiva entre o TAP e a VOP (Spearman = 0,69; p < 0,001), entre o TAP e o AI@75 (Spearman = 0,59, p < 0,001) e relação inversa com o índice tornozelo/braço (Spearman = -0,79; p < 0,001).

Há correlação entre índices de rigidez arterial e o TAP em pacientes com CLTI. Esses indicadores são de importância na quantificação da isquemia do membro.