Comparison of the frequency of abnormal cardiac findings by echocardiography in patients with and without peripheral arterial disease

Peripheral arterial disease (PAD) diagnosed by ankle-brachial index (ABI) evaluation is associated with a high cardiovascular mortality rate. Transthoracic echocardiography (TTE) allows identification of left ventricular (LV) dysfunction and other cardiac findings associated with an increased cardiovascular mortality rate, for which treatments to alter prognosis are available. We sought to determine the prevalence of important TTE abnormalities in outpatients with symptomatic PAD by performing screening TEE. Outpatients without previous echocardiography who had been referred for ABI evaluation for suspected PAD underwent prospective screening TTE. The primary end points were LV dysfunction (LV ejection fraction 0.9, n = 84), and PAD was found to be an independent predictor of LV dysfunction (odds ratio 2.8, 95% confidence interval 1.2 to 6.4) and composite clinically important echocardiographic findings (3.2 95% confidence interval 1.5 to 7.1, p <0.01). In conclusion, outpatients with symptomatic PAD have a high prevalence of clinically important TTE abnormalities, including LV dysfunction, and PAD is an independent predictor of an abnormal echocardiogram.