Relationship between lower limb vascular characteristics, peripheral arterial disease and gait in rheumatoid arthritis
- PMID: 31657155
- DOI: 10.1111/1756-185X.13717
Relationship between lower limb vascular characteristics, peripheral arterial disease and gait in rheumatoid arthritis
Abstract
Objectives: Rheumatoid arthritis (RA) is associated with higher risk of atherosclerotic vascular disease, including peripheral arterial disease (PAD). The aim of this study was to measure lower limb vascular characteristics (indicative of PAD), using non-invasive chairside testing methods, in people with RA compared to matched controls, and to determine the association between vascular characteristics and gait velocity as a measure of functional capacity in people with RA.
Methods: This was a cross-sectional pilot study which measured lower limb vascular characteristics (bilateral continuous wave Doppler, toe brachial index [TBI] and ankle brachial index [ABI]) and gait velocity (6-m walk test) in people with RA and controls. Differences in vascular characteristics between groups were determined using linear regression models, and associations between vascular characteristics and gait were determined using logistic regression models.
Results: Seventy-two participants were included: 34 participants with RA mean disease duration 26.2 (SD 12.1) and 38 age- and sex-matched controls. The control group contained 30 females (79%), and the RA group had 28 females (82%). There were no significant differences between the RA and control groups for lower limb vascular characteristics. People with RA walked significantly slower compared to controls (1.10 m/s vs 0.91 m/s, P < .001). People with RA who had abnormal TBI, or abnormal qualitative Doppler walked significantly slower compared to those with normal TBI (0.86 m/s vs 0.95 m/s, P = .043 and 0.81 m/s, vs 0.93 m/s, P = .028). There was no significant association between ABI and gait velocity.
Conclusion: This study did not identify different lower limb vascular characteristics in people with RA compared to matched controls. However, in people with RA, abnormal Doppler and TBI results are associated with slower walking velocity.
Keywords: Doppler; ankle brachial index; gait; peripheral arterial disease; rheumatoid arthritis; toe brachial index.
© 2019 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Similar articles
-
Toe-brachial index and exercise test can improve the exploration of peripheral artery disease.Atherosclerosis. 2018 Feb;269:151-158. doi: 10.1016/j.atherosclerosis.2018.01.023. Epub 2018 Jan 16. Atherosclerosis. 2018. PMID: 29366987
-
Non-invasive vascular assessment in the foot with diabetes: sensitivity and specificity of the ankle brachial index, toe brachial index and continuous wave Doppler for detecting peripheral arterial disease.J Diabetes Complications. 2016 Jan-Feb;30(1):155-60. doi: 10.1016/j.jdiacomp.2015.07.019. Epub 2015 Jul 21. J Diabetes Complications. 2016. PMID: 26281971
-
Peripheral artery disease, calf skeletal muscle mitochondrial DNA copy number, and functional performance.Vasc Med. 2018 Aug;23(4):340-348. doi: 10.1177/1358863X18765667. Epub 2018 May 8. Vasc Med. 2018. PMID: 29734865 Free PMC article.
-
A systematic review of the sensitivity and specificity of the toe-brachial index for detecting peripheral artery disease.Vasc Med. 2016 Aug;21(4):382-9. doi: 10.1177/1358863X16645854. Epub 2016 May 10. Vasc Med. 2016. PMID: 27165712 Review.
-
The accuracy of toe brachial index and ankle brachial index in the diagnosis of lower limb peripheral arterial disease: A systematic review and meta-analysis.Atherosclerosis. 2020 Dec;315:81-92. doi: 10.1016/j.atherosclerosis.2020.09.026. Epub 2020 Oct 1. Atherosclerosis. 2020. PMID: 33036766 Review.
Cited by
-
Systematic review of associations between concomitant rheumatoid arthritis and peripheral arterial disease, health-related quality of life and functional capacity.Rheumatol Int. 2023 Feb;43(2):221-232. doi: 10.1007/s00296-022-05245-7. Epub 2022 Nov 30. Rheumatol Int. 2023. PMID: 36449056 Free PMC article.
-
Evaluation of the Risk of Getting Peripheral Artery Disease in Rheumatoid Arthritis and the Selection of Appropriate Diagnostic Methods.Cureus. 2020 Aug 16;12(8):e9782. doi: 10.7759/cureus.9782. Cureus. 2020. PMID: 32953298 Free PMC article. Review.
-
Ischemic Heart Disease and Rheumatoid Arthritis-Two Conditions, the Same Background.Life (Basel). 2021 Oct 3;11(10):1042. doi: 10.3390/life11101042. Life (Basel). 2021. PMID: 34685413 Free PMC article. Review.
-
Cardiovascular Risk Assessment in Rheumatoid Arthritis: Accelerated Atherosclerosis, New Biomarkers, and the Effects of Biological Therapy.Life (Basel). 2023 Jan 23;13(2):319. doi: 10.3390/life13020319. Life (Basel). 2023. PMID: 36836675 Free PMC article. Review.
References
REFERENCES
-
- Michelson J, Easley M, Wigley FM, Hellmann D. Foot and ankle problems in rheumatoid arthritis. Foot Ankle Int. 1994;15(11):608-613.
-
- van der Leeden M, Steultjens M, Ursum J, et al. Prevalence and course of forefoot impairments and walking disability in the first eight years of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2008;59(11):1596-1602.
-
- Michaud K, Wolfe F. Comorbidities in rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2007;21(5):885-906.
-
- Rooke TW, Hirsch AT, Misra S, et al. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline): a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2011;58(19):2020-2045.
-
- Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med. 1999;340(2):115-126.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical