BMC medical imaging · 2026
Pedal acceleration time as a diagnostic and prognostic tool in peripheral artery disease: systematic review and meta-analysis.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rosado-Fonseca Mariana, Silva Eduardo, Ribeiro Tiago, Rocha-Melo Antónia, Santos-Silva Daniela, Marques-Vieira Mário, Myrcha Piotr, Ribeiro Hugo, Rocha-Neves João
Аннотация
BACKGROUND: Wound healing in chronic limb-threatening ischaemia in peripheral artery disease (PAD) remains clinically challenging. Accurate perfusion assessment may predict limb outcomes. Standard measures ankle-brachial index (ABI) and transcutaneous oxygen pressure have limitations. The ABI, the guideline-recommended first-line diagnostic tool, has well-recognised limitations in patients. Pedal acceleration time (PAT), measured by duplex ultrasound from onset to peak arterial systole in the pedal arteries, shows promise as a prognostic marker, though its diagnostic and prognostic performance has not been fully validated. This study aimed to perform a systematic review and meta-analysis evaluating PAT's diagnostic accuracy compared with ABI in detecting lower-limb ischaemia. Secondary objectives included assessing PAT's prognostic value for wound healing and amputation risk.
METHODS: Three electronic databases MEDLINE, Scopus, and Web of Science, were systematically searched for studies evaluating PAT values and wound healing in PAD patients. Wound healing incidence and PAT-ABI correlations were pooled according to Preferred Reporting Items for Systematic reviews and Meta-Analyses of Diagnostic Test Accuracy studies (PRISMA-DTA) guidelines. Pooled diagnostic indices, including sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio with 95% confidence intervals were calculated. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Study Quality Assessment Tool for observational cohort and cross-sectional designs.
RESULTS: Seventeen studies (1749 patients) were included as following: 8 cross-sectional, 1 observational prospective, 3 observational retrospective, 4 cohort (3 retrospective, 1 prospective), and 1 case-control study. PAT demonstrated good diagnostic accuracy with pooled 0.72 (95% CI 0.68-0.76) sensitivity, 0.84 (95% CI 0.79-0.88) specificity, 4.38 (95% CI 3.35-5.73) positive likelihood ratio, 0.25 (95% CI 0.19-0.33) negative likelihood ratio, and 14.85 (95% CI 10.02-22.01) diagnostic odds ratio, indicating robust discrimination compared to ABI. The selected studies, referring to the period 2019-2025, reported an association between higher PAT values and worse wound healing outcomes and increased amputation risk. Due to insufficient and non-standardised data, PAT's prognostic pooled analysis for wound healing was not feasible.
CONCLUSION: PAT accurately detected clinically significant lower-limb ischaemia compared to ABI. Faster PAT values correlated to higher ABI and favorable wound healing outcomes, whereas prolonged PAT indicated higher risk of non-healing wounds and major amputation. These results support PAT as a useful duplex-based complement to existing perfusion tests.
METHODS: Three electronic databases MEDLINE, Scopus, and Web of Science, were systematically searched for studies evaluating PAT values and wound healing in PAD patients. Wound healing incidence and PAT-ABI correlations were pooled according to Preferred Reporting Items for Systematic reviews and Meta-Analyses of Diagnostic Test Accuracy studies (PRISMA-DTA) guidelines. Pooled diagnostic indices, including sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio with 95% confidence intervals were calculated. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Study Quality Assessment Tool for observational cohort and cross-sectional designs.
RESULTS: Seventeen studies (1749 patients) were included as following: 8 cross-sectional, 1 observational prospective, 3 observational retrospective, 4 cohort (3 retrospective, 1 prospective), and 1 case-control study. PAT demonstrated good diagnostic accuracy with pooled 0.72 (95% CI 0.68-0.76) sensitivity, 0.84 (95% CI 0.79-0.88) specificity, 4.38 (95% CI 3.35-5.73) positive likelihood ratio, 0.25 (95% CI 0.19-0.33) negative likelihood ratio, and 14.85 (95% CI 10.02-22.01) diagnostic odds ratio, indicating robust discrimination compared to ABI. The selected studies, referring to the period 2019-2025, reported an association between higher PAT values and worse wound healing outcomes and increased amputation risk. Due to insufficient and non-standardised data, PAT's prognostic pooled analysis for wound healing was not feasible.
CONCLUSION: PAT accurately detected clinically significant lower-limb ischaemia compared to ABI. Faster PAT values correlated to higher ABI and favorable wound healing outcomes, whereas prolonged PAT indicated higher risk of non-healing wounds and major amputation. These results support PAT as a useful duplex-based complement to existing perfusion tests.