Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202401042
Jornal Vascular Brasileiro
Artigo Original

New device for assessing the toe-brachial index and a pilot cross-sectional study in diabetic patients

Novo aparelho para avaliação do índice hálux-braquial e uma pesquisa transversal piloto com pacientes diabéticos

Thiago Paes de Barros De Luccia; Alexandre Donisete Bensi; Nelson De Luccia; Priscilla Matos Cunha; Lia Maristela da Silva Jacob; Leonardo Servato Sanches Martins de Barros; Julio Maganha Gouvêa; Vívian Mei Matuoka

http://dx.doi.org/10.1590/1677-5449.202401042 J Vasc Bras, vol.24, e20240104, 2025
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Abstract

Background: Blood pressure measurements in the hallux and fingers are important in evaluation of patients with diabetes, obese patients, dialysis patients, and those with peripheral artery disease.

Objectives: In this article, we tested a prototype of an automatic device for measuring systolic pressure in fingers and toes, combining optical plethysmography and a pressure sensor, with a cuff encircling the finger or toe, and controlled by a microcontroller.

Methods: The prototypes (a total of 3 identical devices) were tested for initial validation (with a group of participants who already had symptoms of peripheral arterial disease [PAD], n=30) and also in clinical comparisons between controls (n=15) and participants with diabetes (n=15). The following variables were tested: Ankle-brachial index; Toe-finger index; Toe-brachial index, and toe pressure in isolation. For validation, the toe pressure in isolation was measured with two devices (the prototype under test and the SysToe® device), to analyze the correlation between the two measurements.

Results: The correlation between the two devices was strong (R=0.88) in the group with symptoms of PAD. Toe-brachial index was lower in patients with diabetes than in control participants (p=0.005) as was the Toe-finger index (p=0.03), however, the Ankle-brachial index was similar in these two groups (p=0.92).

Conclusions: The findings show the feasibility of the device for measuring finger and toe pressures, and possibly indicate greater sensitivity for detecting early-stage arterial disease using this type of measurement.

Keywords

toe brachial index; ankle brachial index; arterial pressure; photoplethysmography

Resumo

Contexto: As medidas de pressão arterial do hálux e dos dedos das mãos são importantes na avaliação de pacientes com diabetes, obesos, em diálise e com doença arterial periférica (DAP).

Objetivos: Neste artigo, testamos um protótipo de dispositivo automático para medição da pressão sistólica nos dedos das mãos e dos pés, associando pletismografia óptica e sensor de pressão, com um manguito envolvendo o dedo da mão ou do pé, controlado por um microcontrolador.

Métodos: Os protótipos (total de três dispositivos idênticos) foram testados quanto à validação inicial (grupo de participantes já com sintomas de DAP, n=30) e também em uma comparação clínica entre controles (n=15) e participantes diabéticos (n=15). As seguintes variáveis foram testadas: índice tornozelo-braquial, índice hálux-digital, índice hálux-braquial e pressão isolada do hálux. Para a validação, a pressão isolada do hálux foi medida com dois dispositivos (protótipo em teste e dispositivo SysToe®), a fim de estabelecer uma correlação entre as duas medidas.

Resultados: A correlação entre os dois dispositivos foi forte (R=0,88) no grupo com sintomas de DAP. O índice hálux-braquial foi menor em diabéticos do que nos controles (p=0,005), assim como o índice hálux-digital (p=0,03). No entanto, o índice tornozelo-braquial foi semelhante entre os dois grupos (p=0,92).

Conclusões: Os achados demonstram a viabilidade do dispositivo para medir as pressões dos dedos das mãos e dos pés, além de indicar uma possível maior sensibilidade para detectar doença arterial em estágio inicial com esse tipo de medição.

Palavras-chave

índice hálux-braquial; índice tornozelo-braquial; pressão arterial; fotopletismografia

Referências

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Submetido em:
03/07/2024

Aceito em:
07/05/2025

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