Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

Abstract

David Rosenbaum1,2, Sandra Rodriguez-Carranza1,3, Patrick Laroche4, Eric Bruckert1,2, Philippe Giral1,2, Xavier Girerd1,21Unité de Prévention Cardiovasculaire, Service d'Endocrinologie-Métabolisme, Assistance Publique/Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière – Université Pierre et Marie Curie, 2Dyslipoproteinemia and Atherosclerosis Research Unit, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC – Paris VI), Paris, France; 3Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Endocrinología y Metabolismo, Delegación Tlalpan, México Distrito Federal; 4STACTIS, Paris, FranceObjective: To evaluate the accuracy of the ankle brachial index (ABI) measured with the SCVL® (“screening cardiovascular lab”; GenNov, Paris, France), an automated device with synchronized arm and ankle cuffs with an automatic ABI calculation.Methods: Patients were consecutively included in a cardiovascular prevention unit if they presented with at least two cardiovascular risk factors. ABI measurements were made using the SCVL, following a synchronized assessment of brachial and ankle systolic pressure. These values were compared to the ABI obtained with the usual Doppler-assisted method.Results: We included 157 patients. Mean age was 59.1 years, 56.8% had hypertension, 22.3% had diabetes mellitus, and 17.6% were current smokers. An abnormal ABI was observed in 17.2% with the SCVL and in 16.2% with the Doppler. The prevalence rates of an abnormal ABI by patient measured with each device, ie, 15.7% (confidence interval [CI] 0.95: [11.8; 20.4]) or 14.3% (CI 0.95: [10.7; 18.9]), did not differ. The coefficient of variation of Doppler and SCVL measures was 15.8% and 15.1%, respectively. The regression line between the two measurement methods was statistically significant. The value-to-value comparison also shows a difference of mean equal to 0.010 (CI 0.95: [–0.272; 0.291]) (r = –0.055). Reproducibility of ABI measurements with the SCVL showed a difference of mean equal to 0.009 (CI 0.95: [–0.203; 0.222]), without heteroscedasticity (r = –0.003). Conclusion: The SCVL is a fast and easy to use automated oscillometric device for the determination of ABI. The use of this two-synchronized-cuff device correlates well with the gold standard Doppler ultrasound method and is reproducible. The SCVL may ease the screening for peripheral arterial disease in routine medical practice.Keywords: ankle brachial index, automated device, peripheral arterial disease screening