Relation of Ankle Brachial Index to Left Ventricular Ejection Fraction in Diabetic Patients

Background: Peripheral arterial disease is associated with an excessive risk for cardiovascular events and mortality. It is usually measured with ankle brachial index (ABI), which is shown to be influenced by left ventricular ejection fraction (LVEF) independent of coronary disease. Diabetics significantly have higher risk for cardiovascular disease. The aim of current study is to evaluate relation of ABI to LVEF in diabetic patients. Methods: Seventy-five diabetics (36% male with mean age of 59.98 +/- 10.27 years) referred for ABI determination that had the LVEF determined using trans-thoracic echocardiography was studied. Participants were compared in normal (ABI > 1, n = 54) and low ABI (ABI < 1, n = 21) groups. Results: The mean LVEF was 48.61 +/- 10.74, and mean ABI for both legs was 1.06 +/- 0.11. There was no difference in demographic findings between ABI low and normal. There was no difference in ABI values according to diabetes duration. In cases with low ABI, LVEF below 50% was higher than normal ABI (85.7% vs. 18.5%, p < 0.001). Peripheral neuropathy existed in 37% of normal ABI and 66.7% of low ABI (P = 0.037). Low ABI was independently associated with LVEF with Odds ratio of 0.04 (confidence interval between 0.01 to 0.17, p < 0.001). Conclusions: ABI would be influenced by LVEF in diabetics, but not considering the diabetes period and to evaluate and monitor cardiovascular risk in patients, these should be considered together.