Establishing normative data for peripheral arterial disease using pulse wave analysis

Peripheral arterial disease (PAD) affects 10-25% of people over the age of 55. It contributes to foot amputation, morbidity and mortality. Accurate and early diagnosis can lessen this public health burden. A current clinical measure of PAD such as the ankle brachial pressure index (ABPI) has low sensitivity and specificity for asymptomatic disease and calcified arteries especially in the diabetic population. Therefore, a new non-invasive evaluation method for lower limb vascularisation has been investigated. Pulse wave analysis (PWA) including peak blood flow velocity (PBFV) and fractal dimension (FD) of the velocity waveform has been investigated in this research. A ldquonon pathologicalrdquo group of students and staff was selected using convenience sampling at Charles Sturt University. We observed two and three peak velocity waveforms (51.7%) which indicate normal flow but also a high occurrence (33.33%) of pre-peaks and four peaks in the pulse wave not reported previously. Normative values were determined for PBFV (95% CI 9.9-37.3 cm/sec) and the fractal dimension (95% CI 1.082-1.261). The results indicate that this study warrants further investigation into the potential for PBFV or FD to be used as a clinical assessment tool to identify early asymptomatic PAD.