Brachial-ankle pulse wave velocity is associated with walking distance in patients referred for peripheral arterial disease evaluation

ObjectiveImpaired functional capacity predicts morbidity and increased mortality in patients with PAD. We hypothesized that brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, is associated with functional capacity in patients undergoing noninvasive evaluation for peripheral arterial disease (PAD).MethodsWe studied 114 patients (age 68 ± 10 years) referred to Mayo Clinic's noninvasive vascular laboratory. Functional capacity was estimated in terms of distance walked in 5 min on a treadmill at a speed of 1.0–2.0 mph. Ankle-brachial index (ABI) was obtained with Doppler method before and 1 min after exercise. baPWV was estimated noninvasively using an oscillometric device. The association of baPWV with walking distance was assessed using accelerated failure time and Cox proportional-hazards models.ResultsThe mean baPWV was higher in patients who were unable to complete the walk test compared to those who successfully completed the test (P = 0.008). Higher baPWV was associated with a lower walking distance after adjustment for heart rate, mean arterial pressure, and cardiovascular risk factors (P = 0.017) and after additional adjustment for pulse pressure (P = 0.034) and ABI (P = 0.030). Higher baPWV was associated with failure to complete the treadmill walk test, after adjustment for heart rate, mean arterial pressure, and cardiovascular risk factors (P = 0.025) and after additional adjustment for pulse pressure (P = 0.041) and ABI (P = 0.039).ConclusionIncreased baPWV, a measure of arterial stiffness, is associated with impaired functional capacity in patients undergoing evaluation for PAD.