Pressure measurements at rest and after heavy exercise to detect moderate arterial lesions in athletes

Histogram of the estimated severity of stenosis in endofibrosis while artery is submitted (echography or arteriography) or not submitted (histology or angioscopy) to intraluminal arterial pressure. A zero value is noted when examination was reported to be normal.

Mean ± SD at rest and after incremental maximal exercise of ankle systolic blood pressure (ASBP ), absolute pressure drop from rest (pressure change ), ankle to brachial index (ABI ), and deviation from normal ABI to heart rate relationship (DAHR ), in healthy athletes (hollow circles ) and in diseased leg (filled squares ) and nondiseased leg (hollow squares ) of subjects referred for suspected external iliac artery endofibrosis.

ABI to HR relationship in 108 healthy athletes (filled circles ) and in diseased leg in EIAE subjects (hollow circles ) at rest and after incremental exercise on cycle ergometer.

Evolution of diagnostic efficiency (area under ROC curve) of the different diagnostic criteria at rest and with time in recovery period from maximal exercise (0.50 would be the result of a random choice, 1.00 the result of an ideal test). a and b show statistically significant differences with both ankle pressure and pressure change for ankle to brachial index (ABI ) and deviation from normal ABI-HR relationship, respectively. DAHR, Deviation from normal ABI to HR relationship; ROC, receiver operating characteristic.

Examples of determination of optimal cutoff point from calculation of the distance of ROC curve to the 100%/100% sensitivity/specificity rate angle for different values of ABI in the discrimination of normal and abnormal results in diagnosis of EIAE. The closer to zero the lower part of the curve, the better the diagnostic performance for the diagnosis of EIAE. The corresponding value on the x-axis is cutoff point to be used. As shown in this example, at different times in recovery period, the diagnostic performance of ABI decreases with time, whereas cutoff point increases toward resting values.