Projects & Grants

Assessment of toe brachial index validity in diabetic patients
Project IdSGS07/LF/2019
Main solverMgr. Ondřej Machaczka, Ph.D.
Period1/2019 - 12/2019
ProviderSpecifický VŠ výzkum
AnotationToe brachial index (TBI) is a special diagnostic method which is an alternative to the ankle brachial index (ABI), and which is similarly used to detect and determine lower extremitiy arterial disease (LEAD). LEAD occurs to a greater extent, with a worse prognosis, progressing faster and occurs earlier in diabetics. Validity of ABI may be reduced due to related complications of diabetes. The most common cause is arterial mediocalcinosis, which makes impossible to accurately determine the systolic pressure on the lower limb or gives false high values. In patients where ankle pressure can not be measured is recommended to measure pressure on the thumb using a special cuff and probe ? the TBI. It is assumed that the arteries on the thumb are less affected by calcification. However, some recent studies show that the use of TBI does not bring any advantage over the ABI in diabetics, and that both methods are closely connected. From our previous research, as well as from the conclusions of other studies, we can see, that the use and interpretation of ABI in diabetics is problematic and ambiguous. This is further complicated by the lack of uniform standards for ABI/TBI methodology and assessment in diabetics. In the Czech Republic, ABI is recommended for all diabetics to detect early atherosclerotic disorder (once a year) and if the ankle pressure can not be measured due to the impossibility of arterial compression, the TBI is recommended. The main objective will be to evaluate the validity of the TBI in diabetics and to determine if this method brings improvements over the ABI. Study group will be formed by patients from the cardiological ambulance BENEDOR, who have proven diabetes. Basic investigation methods will be used to determine the ABI and TBI and lower limb examination will be performed using duplex ultrasonography. This non-invasive method will be used as an examination standard for comparing the results of individual methods and evaluating the validity of TBI.