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 vasualisation has been investigated. Pulse wave analysis (PWA) including peak blood flow velocity (PBFV) and fractal dimension (FD) of the velocity waveform. A 'non pathological' group 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% Cl 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.