A0520 Comparison of Ankle-Brachial Index and Upstroke Time per Cardiac Cycle in Association with Target Organ Damage in Elderly Chinese

Abstract

Objectives: Recent studies indicated that upstroke time per cardiac cycle (UTCC) in lower extremities is equivalent to ankle-brachial index (ABI) in diagnosing peripheral arterial disease and in predicting cardiovascular mortality. In the present study, we aim to compare ABI and UTCC in terms of their association with target organ damage (TOD). Methods: 1841 elderly participants (mean age of 70 years) from the Northern Shanghai Study were included in the present study. ABI and UTCC were measured using VP-1000 device (Omron, Japan). TOD including left ventricular hypertrophy and diastolic dysfunction, carotid intima-media thickness and plaque, carotid-femoral pulse wave velocity (CF-PWV) and renal damage, were all evaluated. Results: ABI and UTCC both were significantly correlated with CF-PWV, carotid plaque and eGFR, but not with cardiac damage. Compared with ABI, UTCC showed stronger correlation with CF-PWV. When ABI and UTCC separately put into same multivariate full-mode logistic regression models, both ABI (Odds Ratio [OR]:2.273; 95% Confidence Interval [CI]:1.632–3.165) and UTCC (OR:1.627; 95%CI: 1.182–2.240) significantly associated with carotid plaque, but only UTCC significantly associated with increased CF-PWV (OR:1.664; 95%CI:1.147–2.416) and renal damage (OR:1.625; 95%CI:1.068–2.472). When ABI and UTCC both put into same multivariate stepwise logistic regression models, consistent results were observed. In ROC curve analysis, UTCC was better than ABI in discriminating increased CF-PWV (AUC:0.68 vs. 0.57; P < 0.001) and renal damage (AUC:0.67 vs. 0.60; P = 0.012). Conclusion: Compared with ABI, UTCC showed stronger association with vascular and renal damage in this elderly cohort. In combination with previous findings, UTCC may be a useful tool for diagnosing PAD and stratifying cardiovascular risk.