HAT: Hand Acceleration Time Assessment With Ultrasound Doppler
Study Details
Study Description
Brief Summary
Chronic upper limb ischemia syndrome is uncommon compared to lower limb ischemia, with several potential causes (e.g., arteriosclerosis, compressive syndromes, arteritis, connective tissue diseases, trauma, and thrombosis). Many patients with upper limb ischemia remain asymptomatic due to arterial collateral vascularization.
Given the wide variety of potential causes for upper limb ischemia, the diagnosis may require different technical approaches. Doppler ultrasound is a noninvasive, accessible, non-radiating technique that provides direct arterial imaging, yielding valuable information on arterial anatomy and hemodynamics.
Some authors have described the reliability of the arterial Doppler ultrasound for lower limb assessment using the pedal acceleration time (PAT). The PAT provides real-time hemodynamic physiological information on the entire limb. The acceleration time is defined as the time elapsed from the beginning of the arterial wave until reaching its peak systolic velocity.
In a healthy individual, this time should be short (between 40 - 100 milliseconds), displaying a triphasic waveform with a systolic acceleration, a sudden diastolic fall, and a subsequent anterograde flow at the end of diastole. A more damped wave suggests proximal stenosis and the acceleration time has been correlated to different degrees of foot ischemia.
Although the acceleration time parameter has also been studied in other territories (e.g., the carotid and pulmonary arteries, coronary arteries, and the aorta), there is no evidence regarding the hand territory. The present study aims to fill this gap.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Healthy Volunteers Lack of upper limb arterial disease. |
Diagnostic Test: Hand Doppler Ultrasound
Hand Doppler Ultrasound to assess the Hand Acceleration Time (HAT)
|
| Patients with Chronic Upper Limb Ischemia Known diagnosis of chronic upper limb ischemia. |
Diagnostic Test: Hand Doppler Ultrasound
Hand Doppler Ultrasound to assess the Hand Acceleration Time (HAT)
|
Outcome Measures
Primary Outcome Measures
- Median (range) hand acceleration time measured by Doppler ultrasound [Day 1]
The hand acceleration time will be measured at the following arteries: Distal radial artery Distal ulnar artery Princeps pollicis artery Index finger radial artery Second common palmar digital artery Fourth common palmar digital artery
Secondary Outcome Measures
- Median (range) age of the participants. [Day 1]
- Number (percentage) of male/female participants. [Day 1]
- Number (percentage) of patients presenting cardiovascular risk factors of interest. [Day 1]
Cardiovascular risk factors of interest are smoking habits, arterial hypertension, diabetes mellitus, and dyslipidemia).
- Number (percentage) of patients with past medical history of interest. [Day 1]
A past medical history of interest is defined as ischemic cardiopathy, heart failure, and chronic obstructive pulmonary disease.
- Presence (Yes/No) of distal pulses in the upper limb. [Day 1]
Eligibility Criteria
Criteria
Inclusion Criteria (healthy volunteers):
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Healthy adult volunteers (≥ 18 years of age).
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No evidence of upper limb arterial disease.
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Who sign the written informed consent.
Exclusion Criteria (healthy volunteers):
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Healthy volunteers unable (at the investigator discretion) to understand or comply with any study-related procedure.
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Healthy volunteers who refuse to participate.
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Those presenting cardiovascular risk factors (e.g., hypertension, diabetes mellitus, dyslipidemia).
Inclusion Criteria (upper limb ischemia patients):
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Adult patients (≥ 18 years of age) with a known diagnosis of chronic upper limb ischemia.
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Who sign the written informed consent.
Exclusion Criteria (upper limb ischemia patients):
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Patients unable (at the investigator discretion) to understand or comply with any study-related procedure.
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Patients who refuse to participate.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Hospital Universitari de Bellvitge | L'Hospitalet De Llobregat | Barcelona | Spain | 08907 |
Sponsors and Collaborators
- Hospital Universitari de Bellvitge
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Sommerset J, Karmy-Jones R, Dally M, Feliciano B, Vea Y, Teso D. Plantar Acceleration Time: A Novel Technique to Evaluate Arterial Flow to the Foot. Ann Vasc Surg. 2019 Oct;60:308-314. doi: 10.1016/j.avsg.2019.03.002. Epub 2019 May 8.
- Strosberg DS, Haurani MJ, Satiani B, Go MR. Common carotid artery end-diastolic velocity and acceleration time can predict degree of internal carotid artery stenosis. J Vasc Surg. 2017 Jul;66(1):226-231. doi: 10.1016/j.jvs.2017.01.041. Epub 2017 Apr 5.
- Takemoto K, Hirata K, Wada N, Shiono Y, Komukai K, Tanimoto T, Ino Y, Kitabata H, Takarada S, Nakamura N, Kubo T, Tanaka A, Imanishi T, Akasaka T. Acceleration time of systolic coronary flow velocity to diagnose coronary stenosis in patients with microvascular dysfunction. J Am Soc Echocardiogr. 2014 Feb;27(2):200-7. doi: 10.1016/j.echo.2013.10.013. Epub 2013 Dec 15.
- Teso D, Sommerset J, Dally M, Feliciano B, Vea Y, Jones RK. Pedal Acceleration Time (PAT): A Novel Predictor of Limb Salvage. Ann Vasc Surg. 2021 Aug;75:189-193. doi: 10.1016/j.avsg.2021.02.038. Epub 2021 Apr 3.
- Wang S, Wang Y, Gao M, Tan Y. Acceleration time to Ejection time ratio in fetal pulmonary artery system can predict neonatal respiratory disorders in gestational diabetic mellitus women. Clin Hemorheol Microcirc. 2022;80(4):497-507. doi: 10.3233/CH-211265.
- Zarzecki MP, Popieluszko P, Zayachkowski A, Pekala PA, Henry BM, Tomaszewski KA. The surgical anatomy of the superficial and deep palmar arches: A Meta-analysis. J Plast Reconstr Aesthet Surg. 2018 Nov;71(11):1577-1592. doi: 10.1016/j.bjps.2018.08.014. Epub 2018 Aug 24.
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