Cardio-ankle vascular index is associated with cardiovascular target organ damage and vascular structure and function in patients with diabetes or metabolic syndrome, LOD-DIABETES study: a case series report.

Manuel Ángel Gómez-Marcos,José Ignacio Recio-Rodríguez,Cristina Agudo-Conde,Jose Angel Maderuelo-Fernandez,Marta Gomez-Sanchez,Leticia Gómez-Sánchez,Emiliano Rodríguez-Sanchez,María Carmen Patino-Alonso,Luís García-Ortiz

doi:10.1186/s12933-014-0167-y

Manuel Ángel Gómez-Marcos, José Ignacio Recio-Rodríguez + Show 7 more

Open Access

https://doi.org/10.1186/s12933-014-0167-y

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Journal: Cardiovascular diabetology	Publication Date: Jan 16, 2015
Citations: 83	License type: CC BY 4.0

Affiliation: Universidad de Salamanca

Abstract

BackgroundThe cardio ankle vascular index (CAVI) is a new index of the overall stiffness of the artery from the origin of the aorta to the ankle. This index can estimate the risk of atherosclerosis. We aimed to find the relationship between CAVI and target organ damage (TOD), vascular structure and function, and cardiovascular risk factors in Caucasian patients with type 2 diabetes mellitus or metabolic syndrome.MethodsWe included 110 subjects from the LOD-Diabetes study, whose mean age was 61 ± 11 years, and 37.3% were women. Measurements of CAVI, brachial ankle pulse wave velocity (ba-PWV), and ankle brachial index (ABI) were taken using the VaSera device. Cardiovascular risk factors, renal function by creatinine, glomerular filtration rate, and albumin creatinine index were also obtained, as well as cardiac TOD with ECG and vascular TOD and carotid intima media thickness (IMT), carotid femoral PWV (cf-PWV), and the central and peripheral augmentation index (CAIx and PAIx). The Framingham-D’Agostino scale was used to measure cardiovascular risk.ResultsMean CAVI was 8.7 ± 1.3. More than half (54%) of the participants showed one or more TOD (10% cardiac, 13% renal; 48% vascular), and 13% had ba-PWV ≥ 17.5 m/s. Patients with any TOD had the highest CAVI values: 1.15 (CI 95% 0.70 to 1.61, p < 0.001) and 1.14 (CI 95% 0.68 to 1.60, p < 0.001) when vascular TOD was presented, and 1.30 (CI 95% 0.51 to 2.10, p = 0.002) for the cardiac TOD. The CAVI values had a positive correlation with HbA1c and systolic and diastolic blood pressure, and a negative correlation with waist circumference and body mass index. The positive correlations of CAVI with IMT (β = 0.29; p < 0.01), cf-PWV (β = 0.83; p < 0.01), ba-PWV (β = 2.12; p < 0.01), CAIx (β = 3.42; p < 0.01), and PAIx (β = 5.05; p = 0.04) remained after adjustment for cardiovascular risk, body mass index, and antihypertensive, lipid-lowering, and antidiabetic drugs.ConclusionsThe results of this study suggest that the CAVI is positively associated with IMT, cf-PWV, ba-PWV, CAIx, and PAIx, regardless of cardiovascular risk and the drug treatment used. Patients with cardiovascular TOD have higher values of CAVI.Trial registrationClinical Trials.gov Identifier: NCT01065155

Highlights

The cardio ankle vascular index (CAVI) is a new index of the overall stiffness of the artery from the origin of the aorta to the ankle
The early detection of atherosclerosis is important for patients with type 2 diabetes mellitus (T2DM) or metabolic syndrome [1], because cardiovascular disease is a main cause of death in these people [2,3].These pathologies are associated with more cardiovascular risk factors [4,5], more comorbidities [6,7], and more renal [8], cardiac [9,10], and vascular [11] target organ damage (TOD)
They occur with increased arterial stiffness [13] based on carotid femoral pulse wave velocity, or with high brachialankle pulse wave velocity could predict all-cause mortality and cardiovascular events in subjects with diabetes [14,15], increased brachial ankle pulse wave velocity (ba-Pulse wave velocity (PWV)) was significantly correlated with cardiac autonomic neuropathy and with subclinical myocardial injury in patients with type 2 diabetes [16].They are associated with pulse wave parameters such as the central and peripheral augmentation indices (CAIX and peripheral augmentation index (PAIx)) [17,18,19]

Summary

Introduction

The cardio ankle vascular index (CAVI) is a new index of the overall stiffness of the artery from the origin of the aorta to the ankle. The early detection of atherosclerosis is important for patients with type 2 diabetes mellitus (T2DM) or metabolic syndrome [1], because cardiovascular disease is a main cause of death in these people [2,3].These pathologies are associated with more cardiovascular risk factors [4,5], more comorbidities [6,7], and more renal [8], cardiac [9,10], and vascular [11] target organ damage (TOD) They are associated with premature vascular aging and altered parameters assessing vascular structure, such as the ankle brachial index (ABI) [12] or carotid intima media thickness (IMT) [11]. The CAVI method is a useful tool to screen people with moderate to advanced levels of atherosclerosis [30]

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