Cardio-ankle Vascular Index Values Research Articles

Cardio-Ankle Vascular Index: Test-Retest Reliability and Agreement in People With Stroke.

The cardio-ankle vascular index (CAVI) is superior to traditional methods of measuring arterial stiffness. However, its application in clinical practice has lagged behind the science. This study aimed to (1) examine its test-retest reliability and agreement between repeated measurements, (2) identify the correlation with fatigue and sleep quality, and (3) compare the CAVI values of the bilateral sides of people with stroke, and those of stroke survivors with and without fatigue. Participants (n = 67) were assessed using the CAVI, Fatigue Assessment Scale, and Pittsburgh Sleep Quality Index. The test-retest reliability ranged from 0.77 to 0.86. The Bland-Altman plots showed good agreement between test and retest. The standard error of measurement ranged from 0.59 to 0.66. The minimal detectable change ranged from 1.15 to 1.29. The CAVI values of the bilateral sides correlated with fatigue and those at the paretic side correlated with sleep quality. The CAVI values of the paretic side were higher than those of the non-paretic side in people with stroke. Stroke participants with fatigue had higher CAVI values than those without fatigue. CAVI has good test-retest reliability and agreement between repeated measurements for clinical use.

Descriptive study of possible relation between cardio-ankle vascular index and lipids in hypertension subjects

Aim: The cardio-ankle vascular index (CAVI) is a new evaluation indicator for arteriosclerosis. This study investigated the relationship between the CAVI and lipid levels in patients with hypertension in a real clinical environment. Methods: This descriptive study enrolled 2,656 patients (male/female: 1,016/1,640) from the Outpatient Department of Vascular Medicine of Peking University Shougang Hospital and Jinding Street Community Health Service Center. CAVI was measured using a VaseraVS-1000 vascular screening system (Fukuda Denshi, Tokyo, Japan). Results: Age, body mass index (BMI), waist circumference, hip circumference, CAVI, systolic blood pressure (SBP), diastolic blood pressure (DBP), creatinine, fasting plasma glucose (FPG), uric acid (UA), hypersensitive C-reactive protein (hs-CRP), homocysteine, HbA1c, and triglyceride (TG) were significantly higher in the hypertension group than in the non-hypertension group. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were significantly lower in the hypertension group than in the non-hypertension group. The CAVI value was significantly higher in patients with hypertriglyceridemia and normal LDL-C than in those with normal TG and hyper-LDL-C. Age, waist circumference, UA, FPG, HDL-C, hs-CRP, HbA1c, BMI, SBP, and DBP were independently associated with CAVI in all patients. Beta blockers were negatively correlated with CAVI (β = –0.411, P = 0.011). Sex (male) and history of hypertension and diabetes mellitus were positively correlated with CAVI (β = 0.419, P < 0.001; β = 0.247, P = 0.011; β = 0.638, P < 0.001; respectively). Conclusions: The CAVI was significantly higher in patients with hypertension and exhibited differences based on sex. Although we did not find a significant correlation between CAVI and TG, it remains crucial to maintain blood pressure to prevent the development of arteriosclerosis.

Relationship between the Mediterranean Diet and Vascular Function in Subjects with and without Increased Insulin Resistance.

(1) The main aim of this study was to analyze the relationship of the Mediterranean diet (MD) with vascular function in participants with and without increased insulin resistance (IR) in the Spanish population. A secondary aim was to study differences by gender. (2) Methods: Data were analyzed from 3401 subjects in the EVA, MARK, and EVIDENT studies (mean age = 60 years and 57% men). IR was evaluated with the triglyceride and glucose index (TyG index). TyG index = Ln [(fasting triglyceride mg/dL × fasting glucose mg/dL)/2]. The MD was measured against the MEDAS questionnaire, with the 14 items used in the PREDIMED study. Vascular stiffness was estimated with the brachial-ankle pulse wave velocity (baPWV) and the cardio ankle vascular index (CAVI) using the Vasera VS-1500®. (3) Results: The mean MEDAS value was 5.82 ± 2.03; (men: 5.66 ± 2.06; women: 6.04 ± 1.99; p < 0.001). MD adherence was 36.8% (men: 34.2%; women: 40.3%; p < 0.001). The mean baPWV value was 14.39 ± 2.78; (men: 14.50 ± 2.65; women: 14.25 ± 2.93; p = 0.005). A baPWV value ≥ 14.5 m/s was found in 43.4% (men: 43.6%; women: 40.0%; p = 0.727). The mean CAVI value was 8.59 ± 1.28; (men: 8.75 ± 1.28; women: 8.37 ± 1.26; p < 0.001). CAVI values ≥ 9 were present in 39.0% (men: 44.4%; women: 31.7%; p < 0.001). The mean value of the TGC/G index was 10.93 ± 1.39; (men: 11.08 ± 1.33; women: 10.73 ± 1.43; p < 0.001). IR was found in 49.9%. The average value of the MD score value was negatively associated with baPWV and CAVI in all groups analyzed (<0.05), except in the group of women with insulin resistance. (4) Conclusions: The results suggest that MD adherence is negatively associated with the vascular stiffness parameters analyzed in all the groups studied except the group of women with insulin resistance.

Association between the Serum Soluble Urokinase Plasminogen Activator Receptor and Peripheral Arterial Stiffness According to the Cardio-Ankle Vascular Index in Patients Undergoing Kidney Transplantation.

High soluble urokinase plasminogen activator receptor (suPAR) levels are correlated with cardiovascular (CV) disease. Arterial stiffness is associated with aging-related vascular diseases and is an independent risk factor for CV morbidity and mortality. It can be measured by the cardio-ankle vascular index (CAVI). We evaluated the association between serum suPAR levels and arterial stiffness according to the CAVI in kidney transplantation (KT) recipients. In this study, 82 patients undergoing KT were enrolled. Serum suPAR levels were analyzed using an enzyme immunoassay. The CAVI was measured using a plethysmograph waveform device, and patients with a CAVI of 9.0 were assigned to the peripheral arterial stiffness (PAS) group. Twenty KT patients (24.4%) had PAS, were of older age (p = 0.042), and had higher serum triglyceride (p = 0.023) and suPAR levels (p 0.001) than the normal group. After adjusting for factors significantly associated with PAS by multivariate logistic regression analysis, serum suPAR levels (odds ratio [OR] 1.072, 95% confidence interval (CI) 1.023-1.123; p = 0.004) were independently associated with PAS in KT patients. The logarithmically transformed suPAR level (log-suPAR) was also positively correlated with the left or right CAVI values (all p 0.001) from the results of the Spearman correlation analysis in KT patients. Serum suPAR levels are positively associated with left or right CAVI values and are independently associated with PAS in KT patients.

Predictive value of Systematic Coronary Risk Evaluation 2-Diabetes risk model and arterial stiffness for cardiovascular events in the Asian population with type 2 diabetes mellitus.

Individuals with diabetes are at high risk of developing cardiovascular events. The present study investigated the predictive value of the cardio-ankle vascular index (CAVI) when added to the Systematic Coronary Risk Evaluation 2-Diabetes (SCORE2-Diabetes) risk algorithm to predict cardiovascular events in the Asian population. The SCORE2-Diabetes risk was assessed in 1,502 patients with diabetes, aged 40-69 years. Then, we further stratified each 10-year risk category with a CAVI value of 9.0. The primary outcomes (composite of all causes of death, myocardial infarction, stroke and hospitalization for heart failure) were assessed over 5 years. The mean age of the population was 59.8 ± 6.4 years. The proportion of 10-year risk according to the SCORE2-Diabetes risk of low, moderate, high and very high risk identified at 7.2, 30.0, 27.2 and 35.6%, respectively. The mean CAVI value was 8.4 ± 1.4, and approximately 35.4% of the patients had CAVI ≥9.0. The SCORE2-Diabetes risk algorithm independently predicted the primary outcomes in patients with diabetes (hazard ratio 1.18, 95% confidence interval [CI] 1.13-1.22), whereas CAVI did not (hazard ratio 1.03, 95% CI 0.89-1.18). The C-index for the primary outcomes of the SCORE2-Diabetes risk algorithm alone was 0.72 (95% CI 0.67-0.77). The combination of SCORE2-Diabetes and CAVI, both in the continuous value and risk groups, did not improve discrimination (C-index 0.72, 95% CI 0.67-0.77 and 0.68, 95% CI 0.64-0.74, respectively). Adding the CAVI to the SCORE2-Diabetes risk algorithm did not improve individual risk stratification in patients with diabetes.

An Increase in Vascular Stiffness Is Positively Associated With Mitochondrial Bioenergetics Impairment of Peripheral Blood Mononuclear Cells in the Older Adults.

The cardio-ankle vascular index (CAVI) is a noninvasive parameter reflecting vascular stiffness. CAVI correlates with the burden of atherosclerosis and future cardiovascular events. Mitochondria of peripheral blood mononuclear cells (PBMCs) have been identified as a noninvasive source for assessing systemic mitochondrial bioenergetics. This study aimed to investigate the relationship between CAVI values and mitochondrial bioenergetics of PBMCs in the older adults.. This cross-sectional study enrolled participants from the Electricity Generating Authority of Thailand between 2017 and 2018. A total of 1640 participants with an ankle-brachial index greater than 0.9 were included in this study. All participants were stratified into 3 groups based on their CAVI values as high (CAVI ≥ 9), moderate (9 > CAVI ≥ 8), and low (CAVI < 8), in which each group comprised 702, 507, and 431 participants, respectively. The extracellular flux analyzer was used to measure mitochondrial respiration of isolated PBMCs. The mean age of the participants was 67.9 years, and 69.6% of them were male. After adjusted with potential confounders including age, sex, smoking status, body mass index, diabetes, dyslipidemia, hypertension, and creatinine clearance, participants with high CAVI values were independently associated with impaired mitochondrial bioenergetics, including decreased basal respiration, maximal respiration, and spare respiratory capacity, as well as increased mitochondrial reactive oxygen species. This study demonstrated that CAVI measurement reflects the underlying impairment of cellular mitochondrial bioenergetics in PBMCs. Further longitudinal studies are necessary to establish both a causal relationship between CAVI measurement and underlying cellular dysfunction.

Cardio-Ankle Vascular Index as a Marker of Left Ventricular Hypertrophy in Treated Hypertensives: Findings From the Pamela Study.

Findings regarding the association between Cardio-Ankle Vascular Index (CAVI) and cardiac hypertension-mediated organ damage (HMOD), such as left ventricular hypertrophy (LVH) assessed by echocardiography, in elderly hypertensive patients are scanty. We sought to investigate this issue in the hypertensive fraction of the general population treated with anti-hypertensive drugs enrolled in the Pressioni Monitorate E Loro Associazioni (PAMELA) study. The study included 239 out of 562 participants who attended the second and third surveys of the PAMELA study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, anthropometric parameters, office, home, ambulatory blood pressure (BP), blood examinations, echocardiography, and CAVI measurements. In the whole study sample (age 69 ± 9 years, 54% males), CAVI was positively correlated with age, office, home, ambulatory systolic BP, LV mass (LVM) index, and negatively associated with body mass index (BMI). In multivariate analysis, CAVI was associated with the LVM index (P < 0.05) independently of major confounders. The participants with LVH exhibited significantly higher CAVI (10.6 ± 2.8 vs. 9.2 ± 1.8 m/s P < 0.001), larger left atrial diameter, and lower LV ejection fraction values than their counterparts without it. The CAVI value of 9.4 m/s was the best cut-off for prediction of LVH in the whole sample. Our study provides new evidence of an independent association between CAVI and LVH in treated elderly hypertensive patients and suggests that the use of this metric of arterial stiffness could not only be used to evaluate vascular damage but also to stratify the risk of LVH.

Increased Cardio-ankle Vascular Index Values in Migraine Patients With Aura.

Patients with migraine with aura are at an increased risk of cardiovascular disease. There are limited data on arterial stiffness in migraine patients with aura. The present study evaluated arterial stiffness in these patients using the cardio-ankle vascular index (CAVI). This prospective study included 50 patients with migraine with aura (43 female, mean age 38.9 ± 9.9years). The patient group was matched for age and gender with 50 healthy individuals with no history of migraine (43 female, mean age 39.3 ± 10.3years). All patients and control subjects underwent a comprehensive clinical evaluation by an experienced neurologist and were interviewed about their headache histories. There was no significant difference in baseline demographic characteristics and echocardiographic parameters between migraine with aura patients and the control group. Both right and left CAVI values were significantly higher in the patients with migraine with aura (6.5 ± 1.2 vs 6.1 ± 0.7, P = .043 and 6.6 ± 1.2 vs 6.1 ± 0.7, P = .009, respectively). Arterial stiffness is an important mediator of cardiovascular diseases. We found that CAVI, a novel marker of the arterial stiffness, is increased in patients with migraine with aura.

Exploring the link between the Naples prognostic score and the cardio-ankle vascular index.

Background: the Naples Prognostic Score is a novel scoring system designed to provide a comprehensive assessment of patients' inflammation and nutritional status. Aim: our aim was to investigate the correlation between the Naples Prognostic Score and arterial stiffness, a factor known to be linked with heart failure and acute coronary syndrome. Materials and methods: this prospective study included 142 consecutive patients without a history of cardiovascular disease, inflammatory disease, immunological disease, malignancy, or comorbid conditions other than hypertension. Patients were categorized into two groups based on their Naples Prognostic Scores: Group 1 (score of 0-2) and Group 2 (score of 3 or 4). Arterial stiffness was assessed using the Cardio-Ankle Vascular Index (CAVI) measured with the VaSera VS-1000 device. CAVI values were compared between the groups. Results: the mean age of the patients was 54 ± 9 years. Group 1 comprised 114 (80.3 %) patients, while Group 2 comprised 28 (19.7 %) patients. There were no significant differences in demographic data between the groups (p > 0.005). Additionally, there were no statistically significant differences between Group 1 and Group 2 regarding left CAVI (7.92 ± 1.45 vs. 8.72 ± 1.85; p = 0.295), right CAVI (7.89 ± 1.52 vs. 8.67 ± 1.34; p = 0.332), or left or right ankle brachial index (p > 0.005). Conclusions: despite previous studies indicating a significant association between the Naples Prognostic Score and heart failure or acute coronary syndrome, our study did not observe a significant correlation between this score and arterial stiffness assessed by CAVI.

Elevated Lipoprotein(a) Levels are Associated with Arterial Stiffness Measured by Cardio-Ankle Vascular Index in Patients Undergoing Peritoneal Dialysis.

Arterial stiffness (AS) can be used to predict future cardiovascular diseases. High lipoprotein(a) (Lp(a)) levels were independently correlated with cardiovascular (CV) morbidity and death in patients with chronic renal insufficiency. The cardio-ankle vascular index (CAVI) is a useful biomarker of arteriosclerotic disorders and has a close relationship with a variety of CV events. This study aimed to investigate the correlation between serum Lp(a) levels and AS in patients on peritoneal dialysis (PD) using the CAVI. A total of 86 adult patients who were on regular PD for at least 3 months were recruited in this study. The CAVI values were determined using the waveform device (VaSera VS-1000). A CAVI value of 9.0 on either side was defined as high. Serum Lp(a) levels were measured by an enzyme-linked immunosorbent assay. Among these participants, 35 of 86 (40.7%) belonged to the high CAVI group. In contrast to those with a normal CAVI, PD recipients in the high CAVI group had higher serum levels of total cholesterol (p = 0.003), triglycerides (p = 0.044), C-reactive protein (p 0.001), and Lp(a) (p 0.001), whereas their albumin levels were significantly lower (p = 0.026). Based on multivariable logistic regression analysis, serum Lp(a) (odds ratio [OR] 1.025, 95% confidence interval [CI] 1.010-1.040, p = 0.001), total cholesterol (OR 1.042, 95% CI 1.005-1.081, p = 0.027), and C-reactive protein (each increase 0.1 mg/dL, OR 1.217, 95% CI 1.008-1.469, p = 0.041) levels were found as the parameters that could independently predict AS in patients on PD. Further, using Spearman's correlation analysis, both the left and right CAVIs revealed a significantly positive correlation with log-transformed Lp(a) levels (r = 0.588, p 0.001; r = 0.639, p 0.001, respectively). Serum Lp(a) levels were postulated to participate in the pathogenic processes of AS in adult patients undergoing PD.

Changes in Arterial Stiffness Monitored Using the Cardio-Ankle Vascular Index in Patients with Rheumatic Disease Receiving Initial Glucocorticoid Therapy: A Clinical Pilot Study.

Systemic inflammatory rheumatic diseases predispose to premature birth, accelerated atherosclerosis, and increased cardiovascular disease (CVD). While glucocorticoids (GCs) are used in various rheumatic diseases, and the associations between GC excess and increased prevalence of CVD complications are well established, the mechanisms underlying GCs' role in atheroma development are unclear. We conducted an observational study to address GC therapy's effect on arterial stiffness using the cardio-ankle vascular index (CAVI) in patients with rheumatic diseases. Twenty-eight patients with rheumatic disease received initial GC therapy with prednisolone at doses ranging from 20 to 60 mg/d. CAVI was examined at baseline and 3 and 6 months after GC therapy. Changes in CAVI and inflammatory parameters were evaluated. GC therapy increased the mean CAVI after 3 months but decreased it to pretreatment levels after 6 months. The mean CAVI substantially decreased with GC treatment in patients <65 years but increased in patients ≥65 years. Alterations in CAVI during the 6-month GC treatment negatively correlated with the lymphocyte-to-monocyte ratio (LMR) at baseline. Conversely, no correlation was observed between alterations in CAVI values and conventional inflammatory markers (C-reactive protein and erythrocyte sedimentation rate). Multivariate analysis of factors related to changes in CAVI highlighted young age, high prednisolone dosage, and LMR at baseline. GC temporarily exacerbates but eventually improves arterial stiffness in rheumatic diseases. Particularly in young patients, GC may improve arterial stiffness by reducing inflammation. Therefore, the LMR before GC therapy in rheumatic diseases may be a potential predictor of arterial stiffness.

The effects of severe periodontitis on arterial stiffness using cardio-ankle vascular index in patients with type 2 diabetes.

Arterial stiffness, which is a measure of the elasticity of the arteries, is also a risk factor for the development of cardiovascular diseases and its measurement is important for evaluating the atherosclerosis process. The purpose of this cross-sectional study to investigate whether severe periodontitis in short-term type 2 diabetes may be associated with increased cardio-ankle vascular index (CAVI) values specified for subclinical atherosclerosis risk. A total of 136 subjects, including 69 subjects with short-term type 2 diabetes (35 with severe periodontitis and 34 with periodontally healthy) and 67 systemically healthy subjects (32 with severe periodontitis and 35 with periodontally healthy) were enrolled to this study. Assessment of all participants included in this study in terms of arterial stiffness was determined by CAVI. Serum fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), triglyceride (TRG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC) and C-reactive protein (CRP) levels were calculated using standard methods. Full mouth periodontal measurements were recorded. Multiple linear regression analysis was performed to evaluate the relationship between periodontal parameters and mean CAVI values of the groups. Mean CAVI levels were significantly higher in diabetic and periodontitis group compared to the other study groups (p < .05). In diabetes and periodontitis group, CAVI was showed positive correlations with CRP (r = .337, p = .048) and HbA1c (r = .442, p = .008). Also, positive significant correlations were found with probing depth (PD) and clinical attachment level (CAL) in the periodontitis groups. Multiple regression analysis revealed that CAL independently predicted CAVI levels in periodontitis groups (β = .433, p = .019 in diabetes and periodontitis groups and β = .57, p = .001 in systemically healthy and periodontitis group respectively). This is the first study investigating the association between severe periodontitis and CAVI in patients with short-term diabetes. Our findings suggest that severe periodontitis may be an intermediate factor in the pathway between type 2 diabetes and cardiovascular disease by increasing the arterial stiffness.

Favorable pattern of arterial stiffness and vascular aging in a unique cohort of offspring of early life famine survivors

The impact of adverse factors in the early life can affect the rate of vascular aging in adulthood and be passed on to the next generations.Aim. To study the characteristics of arterial stiffness and vascular aging phenotypes in two generations of descendants (children and grandchildren) of the siege of Leningrad survivors, compared to a control group.Material and methods. Residents of the siege of Leningrad who experienced famine during early childhood in the Great Patriotic War (19411944) underwent examination between 2009 and 2014. In 2020-2021, 76 descendants of Leningrad siege survivors, aged 18 to 63 years (children — 54 (first generation) and grandchildren — 22 (second generation)), without diagnosed cardiovascular diseases, were examined. Questioning, measurement of blood pressure (BP) and biochemical blood tests were carried out. The cardio-ankle vascular index (CAVI) was determined using the VaSera VS-1500 system (Fukuda Denshi, Japan). Carotid-femoral pulse wave velocity (cfPWV) was assessed using applanation tonometry (SphygmoCor, AtCor, Australia). The phenomenon of supernormal vascular aging was diagnosed with cfPWV £10th percentile of the reference European population, normal vascular aging with cfPWV of 10th-90th percentiles, and early vascular aging with cfPWV ³90th percentile, taking into account age and BP (MattaceRaso F et al., 2010). Several control respondents from the ESSE-RF study (St. Petersburg residents aged 25-64 years) were selected for each descendant, considering generation, sex, age, and BMI. The statistical significance of results was adjusted for multiple comparisons.Results. The average age of descendants of Leningrad blockade survivors was 50 [36,7-55,0] years, which was comparable to the controls, who were 51 [37,5-55,0] years old (p=0,44). The proportion of men in the samples was also comparable — 43,4% vs 42,3% (p=0,88). The cfPWV values were similar in the study and control groups (p=0,4). Only CAVI values were lower in descendants compared to controls, with significant differences observed only in the first generation, regardless of sex (men — 7,6 [7,1;8,3] in the experimental group vs 8,6 [7,6;9,3] in the control group, p=0,02; women — 7,2 [6,7;7,8] in the experimental group vs 7,8 [7,3;8,2] in the control group, p=0,03). The phenotype of early vascular aging was found only in one participant from the experimental group, while the phenomenon of supernormal vascular aging was significantly more prevalent in the age group of 40-49 years in descendants of Leningrad blockade survivors compared to the control group — 25% vs 0% (p=0,01).Conclusion. Only in the first generation of descendants of Leningrad blockade survivors, a favorable pattern of arterial stiffness and a tendency towards a higher prevalence of supernormal vascular aging were observed compared to the control group.

Correlation Between Smoking and Il-1 Level and Arterial Stiffness as Measured By Cavi in the Young Adult Population Without other Cardiovascular Risk Factors.

Background: Recent studies have shown that arterial stiffness is a strong predictor of cardiovascular events and all-cause mortality, with CAVI (Cardio-Ankle Vascular Index) as a non-invasive arterial stiffness testing method in daily practice. Objective: This study was conducted to examine the relationship between smoking -as a risk factor for arterial stiffness- and CAVI values, as well as levels of IL-1β (Interleukin 1β) as a cytokine that plays a role in the pathophysiology of arterial stiffness. Methods: Eighty-four participants, including smokers and non-smokers without other cardiovascular risk factors, were included in the study. Demographic data, medical history, and smoking behavior were taken using a questionnaire, then IL-1β and CAVI levels were examined Results: The mean level of IL-1β in smoking subjects was significantly higher (15.09 ± 0.48) than in non-smoking subjects (5.53 ± 0.79; p=0.001). CAVI values in smoking subjects were also significantly higher (8.0 ± 0.06) than in non-smoking subjects (6.9 ± 0.02; p=0.001). Further analysis showed a strong positive correlation between smoking and IL-1β levels (r=+0.776; p=0.001) and CAVI values (r=+0.759; p=0.001). Conclusion: This study shows that smoking significantly correlates with IL-1β levels and CAVI values. The greater number of cigarettes used per day and the longer duration of smoking, there was a positive correlation between IL-1β levels and arterial stiffness as measured by CAVI.

Cardio-ankle brachial index is associated with prolonged Tp-e interval in patients with arterial hypertension.

The cardio-ankle vascular index (CAVI) is a marker of arterial stiffness, and elevated CAVI values have been reported to be associated with an increased risk of cardiovascular mortality and cardiac arrhythmia. This study aimed to evaluate the relationship between Tp-e interval and CAVI, which is associated with cardiac arrhythmia on electrocardiography (ECG). The study included patients with hypertension whose blood pressure values were taken under control with optimal medical treatment. Arterial stiffness and CAVI were measured using the vascular scanning system VaSera VS-1000. The patients were divided into two groups as CAVI<9 and CAVI≥9. Ventricular repolarization markers QT and QTc intervals, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were measured using 12‑lead ECG. Tp-e interval (78.7±10.3 vs. 63.6±9.1, p<0.001), Tp-e/QT ratio (0.018±0.02 vs. 0.015±0.02, p<0.001), and Tp-e/QTc ratio (0.17±0.02 vs. 0.14±0.04, p=0.025) were statistically significantly higher in the CAVI≥9 group compared to the CAVI<9 group. In the prediction of patients in the CAVI≥9 group, Tp-e interval had an area under the curve value of 0.862 (0.784-0.940, p<0.001) at the cut-off point of >72.5msec, indicating a statistically significant result. Left CAVI and right CAVI were found to be significantly correlated with Tp-e interval (r=-0.650, p<0.001 and r=-0.663, p<0.001, respectively). We found that elevated CAVI values were associated and positively correlated with prolonged Tp-e interval values in patients with hypertension. Patients with elevated CAVI values should be followed up closely to prevent cardiac arrhythmic events.

Serum Malondialdehyde-Oxidized Low-Density Lipoprotein Level Is Associated with Arterial Stiffness by Cardio-Ankle Vascular Index in Coronary Artery Bypass Graft Patients.

A high malondialdehyde-oxidized low-density lipoprotein (MDA-oxLDL) level is associated with atherosclerotic cardiovascular diseases and major adverse cardiovascular events. A higher cardio-ankle vascular index (CAVI) is independently associated with an increased risk of cardiovascular events, cardiovascular mortality, myocardial infarction, and stroke in patients with cardiovascular risk. Thus, this study aimed to evaluate the relationship between serum MDA-oxLDL levels and CAVI in patients with triple-vessel coronary artery disease who underwent coronary artery bypass graft (CABG) surgery. Fasting blood samples and baseline characteristics were obtained from 88 patients who had undergone CABG. A commercialized enzyme-linked immunosorbent assay was used to measure MDA-oxLDL levels. An automatic pulse wave analyzer was used to measure CAVI values, and each side of CAVI values of ≥9 was designated as arterial stiffness. In total, 47 participants were assigned to the arterial stiffness group. More patients had diabetes mellitus, were older, and had higher serum MDA-oxLDL levels in the arterial stiffness group than in the control group. A multivariate logistic regression analysis disclosed that MDA-oxLDL and diabetes mellitus were independent predictors of arterial stiffness. Moreover, according to the Spearman's correlation analysis, the serum MDA-oxLDL level was positively associated with both left and right CAVI. Serum MDA-oxLDL levels were positively associated with arterial stiffness in patients who had undergone CABG.

The role of retinal vessel geometry as an indicator of systemic arterial stiffness assessed by cardio-ankle vascular index.

To determine whether retinal vessel geometry is associated with systemic arterial stiffness, as determined by the cardio-ankle vascular index (CAVI). This single-center retrospective cross-sectional study included 407 eyes of 407 subjects who underwent routine health exams, including CAVI and fundus photography. Retinal vessel geometry was measured using a computer-assisted program (Singapore "I" Vessel Assessment). Subjects were classified into two groups based on CAVI values: high CAVI (≥9) or low CAVI (<9). The main outcome measures included the association of retinal vessel geometry and CAVI value evaluated using multivariable logistic regression models. Three hundred forty-three subjects (343, 84.3%) were in the low CAVI group, and 64 (15.7%) subjects were in the high CAVI group. Multivariable logistic linear regression analyses adjusted for age, sex, body mass index, smoking status, mean arterial pressure, and the presence of hypertension, diabetes mellitus, and dyslipidemia showed a significant association between high CAVI values and the following retinal vessel geometry parameters: central retinal arteriolar equivalent caliber (CRAE; adjusted odds ratio [AOR], 0.95; 95% confidence interval [CI], 0.89-1.00; P = 0.043), fractal dimension of arteriolar network (FDa; AOR, 4.21 × 10-4; 95% CI, 2.32 × 10-7-0.77; P = 0.042), and arteriolar branching angle (BAa; AOR, 0.96; 95% CI, 0.93-0.99; P = 0.007). Increased systemic arterial stiffness had a significant association with retinal vessel geometry related to arterial narrowing (CRAE), less branching complexity of the arterial tree (FDa), and acute arteriolar bifurcation (BAa).

Comparative analysis of START and CAVI arterial stiffness scores in hypertensive patients

Aim. To compare the novel arterial stiffness index START and the cardio-ankle vascular index (CAVI) in hypertensive (HTN) patients. Material and methods. A total of 709 people with HTN aged 24 to 64 years were examined by volume sphygmography using VaSera VS-1000 (Fukuda Denshi, Japan). CAVI and START values obtained retrospectively from pulse wave velocity and blood pressure were studied using an online calculator.Results. The median CAVI score was within the normal range (&lt;9,0): 7,5 (6,6; 8,4) on the right and 7,4 (6,5; 8,4) on the left. The median of the START index was 6,25 (5,0; 7,55) on the right and 6,4 (5,1; 7,8) on the left. For young people (21-30 years old), the median START score was 4,47, for the CAVI index — 6,25 (p&gt;0,05). In the older age group (61-70 years), the median START index was 7,27, for the CAVI index — 8,4 (p&gt;0,05). The growth pattern of the START score with age was higher by 38,5% than the CAVI index by 25,6% (p=0,034). A high degree of correlation between CAVI and START was noted (r=0,823, p&lt;0,001). Parameters were associated with age (r=0,412 for CAVI and r=0,355 for START; p&lt;0,001), smoking duration (r=0,390 and r=0,361; p&lt;0,001), glomerular filtration rate (r=-0,317 and r= -0,318; p&lt;0,001), body mass index (r=-0,176 and r=-0,185; p=0,001). For the CAVI index, a relationship was found with the glucose level (r=0,192; p&lt;0,001) and a sedentary lifestyle (r=-0,157; p=0,04), while for the START index — with the creatinine level (r=0,143; p=0,01).Conclusion. Patients with hypertension showed a high correlation between the novel START index and the CAVI score (r=0,823, p&lt;0,001). The indicators had similar associations with risk factors, which is important for the subsequent practical application of the START index.

PS-C12-9: CARDIO ANKLE VASCULAR INDEX AS A PREDICTOR OF SUCCESSFUL RENAL DENERVATION AND IMPROVED BP VARIABILITY IN SUBJECTS WITH RESISTANT HYPERTENSION

Objective: The aim of the study was to determine the clinical characteristics of patients with increased arterial stiffness (AS) undergoing renal sympathetic denervation (RSD) and to examine the role of cardio ankle vascular index (CAVI) measurement in predicting the outcome of RSD. Another task was to assess the effect on the indices of blood pressure variability. Design and method: Consecutive patients with resistant hypertension who underwent RSD workout at the University Hospital Saint Anna, Sofia, between January 2014 and December 2020 were included. CAVI was measured using the VaSera system (Fukuda Denshi Co, Japan). RSD was performed with the Symplicity Flex catheter (Medtronic, Minneapolis, MN, USA) according to a standardized protocol. Blood pressure variability was assessed by weighted 24 h BPV by ABPM. Results: The study included 62 patients with treatment resistant hypertension, after out of office blood pressure measurement and intensification of therapy, renal denervation was performed in 32 (51.6%). Patients with increased arterial stiffness, defined as CAVI &gt;median of 8.3, were older, with a larger waist circumference and previous cardiovascular events. A longterm effect of the RSD, reported as a reduction in 24-hour systolic blood pressure above 10 mmHg at month 12, was found in 22 patients (68.8%). The median of the observed reduction of the 24 hour systolic blood pressure was 16 mmHg at 95% confidence interval 9.1 to 21 mmHg. Despite similar baseline out of office and office blood pressure and concomitant antihypertensive therapy, patients with lower arterial stiffness had a more significant blood pressure effect of renal denervation, a result that persisted within 12 months of follow up. More profound and significant drop of BP variability was also noticed in this group of patients. In contrast, the effect of the procedure was clinically insignificant among patients with baseline CAVI values above 8.3. Difference in office and out of office BP between the baseline values and those at month 12 after RSD in patients with low arterial stiffness. Conclusions: These findings hold the promise that AS might be used as a selection criterion for RSD, thereby improving outcome following RSD.

Relationship Between Cardio-Ankle Vascular Index And Coronary Artery Calcification In A Population Sample Of Southwestern Siberia

Objective — To examine associations between cardio-ankle vascular index (CAVI) and coronary artery calcium (CAC) score a population sample of southwestern Siberia. Methods — From the sample of 1,620 people the final analysis included 1,316 participants 25 to 64 years of age who were enrolled in an observational cross-sectional study, Epidemiology of Cardiovascular Diseases and Their Risk Factors in the Russian Federation (ESSE-RF). Study participants were split among two groups: Group 1 with CAVI≥9.0 (n=128) and Group 2 with CAVI&lt;9.0 (n=1,188). Prevalence of coronary artery calcification in both groups was analyzed via the Agatston method. We compared main demographic and clinical data between the groups, as well as CAC scores. Results — Elevated CAVI (≥9.0) was present in 9.7% of people included in a population sample from southwestern Siberia, and coronary artery calcification was found in 33.5% of the sample. While similar rates of minimum, mild, moderate and severe CAC score were observed in the participants with elevated and normal CAVI values, CAVI as a continuous variable was statistically significantly associated with moderate and severe CAC scores (OR 1.20, 95% CI 1.06-1.37, p=0.004). CAC score values were higher in individuals at the age of ≥50 years with pathological CAVI values (116±489 vs. 75±425 in normal CAVI, p=0.035), but not in patients under the age of 50 years (64±227 and 85±475, p=0.343). Conclusion — CAVI could possibly be used as a feasible marker before assessing the CAC score in some asymptomatic Caucasian subjects, but identifying the most appropriate methods and participants, whom it could be clearly applicable to, requires further studying.