Uno sforzo isometrico per la diagnosi delle arteriopatie obliteranti croniche degli arti inferiori [An isometric exercise for the diagnosis of chronic obliterating arteriopathies of the lower extremities]

A non-invasive method for the diagnosis of occlusive diseases of the peripheral arteries and the followup of therapy is proposed. The method consists in the performance of an isometric effort of the inferior limbs and Doppler detection of the dorsalis pedis systolic pressure. 41 patients with different degrees of peripheral artery involvement were studied and the results compared with those obtained in a control group of 12 normal subjects, equally matched for age and sex. In the normal subjects, the maximal dorsiflection of the feet for 30 seconds caused a mean increase of the heart rate of 20% and no changes of the systolic blood pressure. In the patients with peripheral artery disease, the isometric effort caused, contemporary to the increase of the heart rate, a decrease of the dorsalis pedis systolic pressure, that varied from 15 to 100% according to the degree of the arterial involvement. A close correlation was found between the degree of the percent reduction of peripheral systolic pressure and the entity of the arterial involvement, as evidenced by other invasive and non-invasive methods. The method proposed appears useful for a proper diagnosis of peripheral vascular diseases in those patients who cannot undergo invasive investigations or the treadmill effort test.