Cardio-ankle Vascular Index Research Articles

Eotaxin and cardio-ankle vascular index in patients with high and very high cardiovascular risk

Eotaxin is a chemokine, which is a chemoattractant mainly to eosinophils, as well as basophils and Th2 lymphocytes. According to studies, overexpression of eotaxin is found in endothelial and smooth muscle cells of blood vessels in the area of atherosclerotic plaque. In clinical medicine, cardio-ankle vascular index (CAVI) is widely used as an indicator of arteriosclerosis and a predictor of cardiovascular events. Few studies have shown the relationship of eotaxin with coronary atherosclerosis; in other studies, the relationship of eotaxin with atherosclerosis, myocardial infarction and pulse wave velocity was not revealed. The aim of the present study was to assess blood level of eotaxin and cardio-ankle vascular index and their association with major cardiovascular risk factors in patients with high and very high cardiovascular risk. We examined 65 patients with high and very high cardiovascular risk, due to documented coronary artery disease, type 2 diabetes mellitus, or combination of cardiovascular risk factors and who were undergoing generally accepted cardioactive, hypoglycemic therapy and lipid-lowering therapy. All patients were examined for the elastic properties of the vascular wall by volumetric sphygmography with assessment of CAVI. In the blood, the concentrations of eotaxin, high-sensitivity C-reactive protein, glycosylated hemoglobin and lipid spectrum indicators were determined. All examined were divided into two groups: with a normal value of CAVI (less than 8) and elevated. Patients with elevated CAVI had higher concentrations of eotaxin (p = 0.013), total cholesterol (p = 0.009), low-density lipoprotein cholesterol (p = 0.016), were older (p < 0.0001) and less likely to take statins (p = 0.002). In all those examined, correlations were found between serum eotaxin concentration and CAVI (rs = 0.34; p = 0.005), as well as age (rs = 0.32; p = 0.006). The age of the patients correlated with CAVI (rs = 0.35; p = 0.007). Thus, in our study, we for the first time showed the relationship between higher concentrations of eotaxin and an increased cardio-ankle vascular index in patients with high and very high cardiovascular risk. Cardio-ankle vascular index was associated with age, lipid metabolism and lipid-lowering therapy. The obtained results allow us to consider eotaxin as a factor associated with atherogenesis and arterial stiffness.

IMPACT OF DIABETES MELLITUS ON ARTERIAL STIFFNESS, AND PULSATILE HEMODYNAMICS IN HEART FAILURE WITH PRESERVED EJECTION FRACTION

Objective: The aim of the current study was to characterize different parameters of arterial stiffness and pulsatile hemodynamics in patients with arterial hypertension and metabolic syndrome according the presence of diabetes mellitus and diastolic dysfunction. Design and method: 121 consecutive patients with left ventricular ejection fraction > 40% were included in the study. LV diastolic function was assessed using pulsed wave Doppler on transthoracic echocardiography. Brachial-ankle pulse wave velocity (baPWV) and the cardio-ankle vascular index (CAVI) was measured using a VaSera VS-1500® device (Fukuda Denshi). Ambulatory BP monitoring over 24 hours was performed using the Mobilograph device (IEM, Stolberg, Germany) which measures brachial and central (aortic) BP, as well as time-resolved waveforms, allowing for ambulatory pulse wave analysis (including wave separation into forward and backward waves and reflection magnitude) Results: Among 121 patients included, diabetes mellitus was present in 55 (54.5%) and diastolic dysfunction in 54 (45.4%). The presence of impaired myocardial relaxation on echocardiography was associated with markedly increase of arterial stiffness parameters – CAVI (8.7 vs 8.1, p = 0.03), PWV (8.8 vs 7.9, p = 0.001), central hemodynamics - central SBP (129.4 vs 114 mmHg, p<0.001), cardiac output and total peripheral resistance (1.34 vs 1.25, p = 0.001) and pulsatile hemodynamics - with reduced reflection magnitude (60.7 vs 63, p = 0.04). Diabetic subjects with HFpEF exhibited a markedly greater left ventricular wall thickness and left atrium size on echocardiography. Pronounced aortic stiffening was also observed in the diabetic group (pulse wave velocity, 8.7 vs 7.9, p, 0.001; cardio-ankle vascular index, 9.1 vs 7.8, p<0.001), with an adverse pulsatile hemodynamic profile characterized by increased forward and backward wave amplitude and reduced reflection magnitude (61 vs 64.8, p = 0.05). Conclusions: The presence of diastolic dysfunction is associated with changes of arterial stiffness and pulsatile hemodynamics. Diabetes mellitus is a key determinant of left ventricular remodeling, arterial stiffness, adverse pulsatile hemodynamics, and ventricular-arterial interactions in HFpEF.

LONG TERM EFFECT OF RENAL DENERVATION ON 24 HOUR ABPM AND BLOOD PRESSURE LOAD IS LARGELY DEPENDENT OF BASELINE ARTERIAL STIFFNESS

Objective: The aim of the study was to evaluate the long term effect of renal sympathetic denervation (RSD) on 24h ambulatory blood pressure measurement (ABPM) and blood pressure load (BP load) in patients with resistant hypertension depending of the baseline arterial stiffness status. Design and method: Consecutive patients with resistant hypertension who underwent RSD workout at the University Hospital Saint Anna, Sofia, ESH Excellence center of hypertension, were included. RSD was performed on the grounds of resistant hypertension defined as mean daytime systolic BP >135 mmHg or diastolic BP >85 mmHg in 24-hr ambulatory blood pressure measurement (ABPM) despite the intake of at least three antihypertensive agents, including a diuretic. Cardio ankle vascular index (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. Results: The study included 32 patients with treatment-resistant hypertension and performed successful RSD. CAVI was measured before the intervention and the results of the procedure on 24h daytime, nighttime and 24 blood pressure and systolic and diastolic BP load were evaluated by serial ABPM measurements. A long-term 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%). 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. Along with reduction of all ABPM parameters more profound and clinically meaningful change of BP load during daytime, nighttime and 24h period was also noticed in this group of patients. (Table 1) Conclusions: The long term effect of renal denervation on 24h ABPM and BP load is largely dependent of baseline arterial stiffness. The results of the present study justify the incorporation of arterial stiffness evaluation in clinical decision workout of the procedure.

Markedly Low Cardio-Ankle Vascular Index in Aortic Valve Stenosis: Vital Possible Cause Not to Be Overlooked [Letter

Markedly Low Cardio-Ankle Vascular Index in Aortic Valve Stenosis: Vital Possible Cause Not to Be Overlooked [Letter

Relationship of serum lipid parameters with kidney function decline accompanied by systemic arterial stiffness: a retrospective cohort study.

Dyslipidemia is associated with kidney function decline (KFD), although the non-linear relationship of lipid parameters to KFD has not been fully elucidated. We aimed to determine the detailed relationship of baseline lipid parameters with KFD, considering the mediation of arterial stiffness. A total of 27 864 urban residents with estimated glomerular filtration rate (eGFR) ≥60mL/min/1.73 m2 at baseline, who participated in a median of three (range two to eight) consecutive annual health examinations were studied. Arterial stiffness was assessed by cardio-ankle vascular index (CAVI). KFD was defined as development of eGFR <60mL/min/1.73 m2. During the study period, 1837 participants (6.6%) developed KFD. Receiver operating characteristic analysis determined that the cutoff values independently associated with KFD are 123mg/dL for low-density lipoprotein cholesterol (LDL-C) [area under the curve (95% confidence interval) 0.570 (0.557-0.583)], 65mg/dL for high-density lipoprotein cholesterol (HDL-C) [0.552 (0.539-0.566)], 82mg/dL for triglycerides (TG) [0.606 (0.593-0.618)] and 1.28 for TG/HDL-C ratio [0.600 (0.587-0.612)]. These cut-offs were independently associated with KFD in Cox analysis. Regarding the contribution of each lipid parameter to KFD, a linear relationship was observed for both TG and TG/HDL-C, and a U-shaped relationship for HDL-C. A adjusted mediating effect of CAVI on the relationship of TG or TG/HDL-C ratio with KFD was observed (mediating rate: 2.9% in TG, 2.5% in TG/HDL-C ratio). Regarding the association to KFD, a linear relationship was observed for both TG and TG/HDL-C, and a U-shaped relationship for HDL-C. A mediating effect of CAVI on the relationship of TG or TG/HDL-C ratio with KFD was observed after adjustment for confounders. TG and TG/HDL-C ratio related linearly to KFD and this was partially mediated by CAVI. A U-shaped relationship was observed between HDL-C and KFD risk. LDL-C showed no significant association. Further study should investigate whether intensive TG-lowering treatment prevents KFD via decreasing CAVI.

Association between cardio-ankle vascular index and cardiometabolic risk factors in HIV patients in Ghana

ABSTRACT Human immunodeficiency virus (HIV) infection is associated with increased cardiovascular diseases (CVDs) even in patients with viral suppression by combination antiretroviral therapy (cART). Arterial stiffness is an independent predictor of CVDs in diseased individuals and the general population. Cardio-ankle vascular index (CAVI) is an index of arterial stiffness that has been shown to predict target organ damage. CAVI is less studied in HIV patients. We compared the levels of arterial stiffness using CAVI and associated factors among cART-treated and cART-naïve HIV patients to those of non-HIV controls. In a case-control design, 158 cART-treated HIV patients, 150 cART-naïve HIV patients and 156 non-HIV controls were recruited from a periurban hospital. We collected data on CVD risk factors, anthropometric characteristics, CAVI, and fasting blood samples to measure plasma glucose, lipid profile, and CD4+ cell counts. Metabolic abnormalities were defined using the JIS criteria. CAVI increased in cART-treated HIV patients compared to cART-naïve HIV patients and non-HIV controls (7.8 ± 1.4 vs 6.6 ± 1.1 vs 6.7 ± 1.4 respectively, p < 0.001). CAVI was associated with metabolic syndrome in non-HIV controls [OR (95% CI) = 2.14 (1.04–4.4), p = 0.039] and cART-naïve HIV patients [1.47 (1.21–2.38), p = 0.015], but not in cART-treated HIV patients [0.81 (0.52–1.26), p = 0.353]. In cART-treated HIV patients, a tenofovir (TDF)-based regimen (β = −0.46, p = 0.023) was associated with decreased CAVI and decreased CD4+ cell count (β = −0.23, p = 0.047) was associated with increased CAVI. In a periurban hospital in Ghana, compared to non-HIV controls or cART-naïve HIV patients, cART-treated HIV patients had increased arterial stiffness measured as CAVI. CAVI is associated with metabolic abnormalities in non-HIV controls and cART-naïve HIV patients, but not in cART-treated HIV patients. Patients on TDF-based regimens had decreased CAVI.

Nighttime home blood pressure lowering effect of esaxerenone in patients with uncontrolled nocturnal hypertension: the EARLY-NH study

There is limited evidence on the blood pressure (BP)-lowering effect of esaxerenone on home BP, including nighttime BP. Using two newly developed nocturnal home BP monitoring devices (brachial and wrist), this multicenter, open-label, prospective study investigated the nighttime home BP-lowering effect of esaxerenone in patients with uncontrolled nocturnal hypertension being treated with an angiotensin receptor blocker (ARB) or calcium-channel blocker (CCB). In total, 101 patients were enrolled. During the 12-week study period, change in nighttime home systolic/diastolic BP from baseline to end of treatment measured by the brachial device was −12.9/−5.4 mmHg in the total population and −16.2/−6.6 and −10.0/−4.4 mmHg in the ARB and CCB subcohorts, respectively (all p < 0.001). For the wrist device, the change was −11.7/−5.4 mmHg in the total population and −14.6/−6.2 and −8.3/−4.5 mmHg in each subcohort, respectively (all p < 0.001). Similar significant reductions were shown for morning and bedtime home BP and office BP. Urinary albumin-to-creatinine ratio, N-terminal pro-brain natriuretic peptide, and cardio-ankle vascular index improved in the total population and each subcohort. Incidences of treatment-emergent adverse events (TEAEs) and drug-related TEAEs were 38.6% and 16.8%, respectively; most were mild or moderate. The most frequent drug-related TEAEs were associated with serum potassium elevation (hyperkalemia, 9.9%; blood potassium increased, 3.0%); however, no new safety concerns were raised. Esaxerenone was effective in lowering nighttime home BP as well as morning and bedtime home BP and office BP, safe, and showed organ-protective effects in patients with uncontrolled nocturnal hypertension. Caution is warranted regarding elevated serum potassium levels.This study investigated the effect of esaxerenone on nighttime home BP and organ damage (UACR and NT-proBNP) in patients with uncontrolled nocturnal hypertension despite treatment with an ARB or CCB. Our results show that safe 24-h BP control and organ protection are possible with esaxerenone.

Cardio-ankle vascular index predicts postoperative atrial fibrillation after cardiac surgery.

Cardio-ankle vascular index predicts postoperative atrial fibrillation after cardiac surgery.

A Pilot Estimation of Ventricular-Arterial Coupling Using a Vascular Screening Device (VaSera®).

Non-invasive cardiovascular assessment has become an alternative to invasive techniques. VaSera®, a vascular screening device, measures arterial stiffness with the cardio-ankle vascular index (CAVI); it also measures cardiophysiological variables of ejection time (ET) and pre-ejection period (PEP). We aimed to apply the parameters obtained by VaSera® to estimate heart function based on left ventricular end-systolic elastance/arterial elastance (Ees/Ea) and to assess the minimal required number of measurements for estimation. We conducted an experimental laboratory study for healthy volunteers. Using the previously established formula, the Ees/Ea value of each participant was estimated using ET and PEP values measured by VaSera®. The intraclass correlation coefficient (ICC) assessed the minimum required number of measurements. Concordance correlation coefficient (CCC) and Bland and Altman analysis assessed variation of Ees/Ea estimation against the trimmed average. A total of 660 measurements from 132 participants were included. The Ees/Ea estimates from the VaSera® were 1.5 [1.2, 1.9]. The ICC for Ees/Ea was 0.71 (95% confidence interval: 0.65-0.77), suggesting that four measurements were required. The CCC between the trimmed average of Ees/Ea and the mean of four Ees/Ea estimates was 0.99. Bland and Altman analysis showed excellent agreement for the mean of four Ees/Ea estimates and the trimmed average of Ees/Ea. For screening of heart failure, the Ees/Ea estimated using non-invasive vascular-stiffness assessment device would be tolerable and four sequential measurements were required.

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.

The indicators of vascular endothelium function in patients with chronic obstructive pulmonary disease after COVID-19

Aim. To analyze indicators of the vascular endothelium function in patients with chronic obstructive pulmonary disease (COPD) depending on the COVID-19 history.Materials and methods. 98 patients with stable COPD who had COVID-19, regardless of the severity of the infection, were examined 4-8 weeks after discharge from the infectious disease hospital (Group 1). The comparison group included 50 patients with stable COPD without a history of COVID-19 (Group 2). To assess the vascular endothelium function, in all patients the following were determined: endothelin-1 (ET-1, fmol/L), total homocysteine (Hcy, µmol/L), antigen to von Willebrand factor (vWF, fmol/L), C-reactive protein (CRP, mg/L). The following parameters of arterial stiffness (AS) were recorded using sphygmomanometry (Vasera-1000, Japan): pulse wave velocity (PWV, m/s), right/left cardio-ankle vascular index (R/L-CAVI, units), augmentation index on the right shoulder (R-AI, units), augmentation index on the common carotid artery (C-AI, units).Results. The concentration of biomarkers Hcy, ET-1, vWF in the 1st group was significantly higher than in the 2nd group (p&lt;0.01, p&lt;0.05 and p&lt;0.05, respectively). The studied parameters of AS in patients with COPD were significantly higher than the reference values, regardless of the presence of a COVID-19 history. In patients of the 1st group, the indices R-AI and CAI (p&lt;0.05) were significantly higher than in patients of the 2nd group. Correlation analysis showed relationships between R-CAVI and CRP (r=0.513, p&lt;0.001) and CRP and ET-1 (r=0.485, p&lt;0.01).Conclusion. In patients with COPD, the past COVID-19 leads to more significant shifts in the functional activity of the vascular endothelium than in isolated COPD of a stable course and is associated with active systemic inflammation.

Arterial Stiffness as A Predictor of Future Cardiovascular Events: Methods of Measurement and Clinical Implications

Arterial stiffness has recently emerged as strong predictor of cardiovascular events, including coronary heart disease. The cardio-ankle vascular index (CAVI) is a novel index that measures the overall stiffness of the artery all the way from the point where it branches off from the aorta to the ankle. CAVI's ability to provide accurate results regardless of the patient's blood pressure at the moment of measurement is without a doubt its most valuable characteristic. CAVI is related to many cardiovascular risk factors, including hypertension, diabetes mellitus, dyslipidemia, and smoking. It also increases with age and in many arteriosclerotic diseases, such as coronary artery disease, carotid arteriosclerosis, chronic kidney disease, and cerebrovascular disease. CAVI also increases in patients who have cerebrovascular disease. Controlling conditions such as diabetes mellitus and hypertension, in addition to quitting smoking, may also reduce the risk of CAVI. This indicates that CAVI is a physiological surrogate measure of atherosclerosis, and it also implies that it might be a signal of lifestyle change. Recent research has shown that CAVI and numerous functions of the left ventricle are linked to one another, which points to a linkage between the heart muscle and vascular function. This study discusses the fundamentals of CAVI as well as our present understanding of the measurement, with a particular emphasis on its functions and potential future use.

Establishment of an Individual-Specific Nomogram for Predicting the Risk of Left Ventricular Hypertrophy in Chinese Postmenopausal Hypertensive Women.

Background and Objectives: The physiological phenomenon peculiar to women, namely menopause, makes the occurrence of left ventricular hypertrophy (LVH) in postmenopausal hypertensive women more characteristic. Less is known about the risk of developing LVH in Chinese postmenopausal hypertensive women. Thus, the present study was intended to design a nomogram for predicting the risk of developing LVH in Chinese postmenopausal hypertensive women. Materials and Methods: Postmenopausal hypertensive women aged between 49 and 68 years were divided into either the training set (n = 550) or the validation set (n = 284) in a 2:1 ratio. Patients in the validation set were followed up for one year. A stepwise multivariable logistic regression model was used to assess the predictors of LVH in postmenopausal women with hypertension. The best-fit nomogram was executed using R software. The calibration and decision curve were employed to verify the predictive accuracy of the nomogram. The results were evaluated in the validation set. Results: Menopause age (OR = 0.929, 95% CI 0.866-0.998, p = 0.044), BMI (OR = 1.067, 95% CI 1.019-1.116, p = 0.005), morning systolic blood pressure (SBP: OR = 1.050, 95% CI 1.032-1.069, p = 0.000), morning diastolic BP (DBP OR = 1.055, 95% CI 1.028-1.083, p = 0.003), angiotensin II receptor blocker (ARB) utilization rate (OR = 0.219, 95% CI 0.131-0.365, p = 0.000), LDL-C (OR = 1.460, 95% CI 1.090-1.954, p = 0.011) and cardio-ankle vascular index (CAVI) (OR = 1.415, 95% CI 1.139-1.757, p = 0.028) were associated with LVH in postmenopausal hypertension patients. The nomogram model was then developed using these variables. The internal validation trial showed that the nomogram model described herein had good performance in discriminating a C-index of 0.881 (95% CI: 0.837-0.924) and high quality of calibration plots. External validation of LVH-predictive nomogram results showed that the area under the ROC curve was 0.903 (95%CI 0.900-0.907). Conclusions: Our results indicate that the risk prediction nomogram model based on menopausal age, BMI, morning SBP, morning DBP, ARB utilization rate, LDL-C and CAVI has good accuracy and may provide useful references for the medical staff in the intuitive and individualized risk assessment in clinical practice.

Possible Clinical Benefits of Cardio-Ankle Vascular Index Measurement in Urological Diseases.

Many factors are considered to affect vascular physiology. It is known that one of the reasons for many diseases is a pathology at the microvascular level. Therefore, the relationship between endothelial dysfunction and many diseases is currently being investigated. The clinical evaluations of arterial stiffness have made it possible to perform necessary risk assessment regarding cardiovascular diseases. In this way, protective measures can be taken against microvascular pathologies in many organs. In this paper, we present a review of studies investigating the relationship between urological conditions and the cardio-ankle vascular index (CAVI), a marker of arterial stiffness. As with erectile dysfunction, some studies have shown that conditions such as lower urinary tract symptoms, overactive bladder, and chronic kidney disease are also associated with an elevated CAVI. The association of erectile dysfunction and chronic kidney disease with vascular pathologies has been clearly demonstrated. In addition, lower urinary tract symptoms may be the first sign of silent vascular dysfunction. Assessing arterial stiffness with CAVI can help prevent future cardiovascular events in these patients.

The Effects of Topiroxostat, a Selective Xanthine Oxidoreductase Inhibitor, on Arterial Stiffness in Hyperuricemic Patients with Liver Dysfunction: A Sub-Analysis of the BEYOND-UA Study

The effects of uric acid (UA)-lowering therapy with xanthine oxidoreductase (XOR) inhibitors on the development of cardiovascular diseases remain controversial. Based on recent findings that plasma XOR activity increased in liver disease conditions, we conducted a sub-analysis of the BEYOND-UA study to examine the differential effects of topiroxostat on arterial stiffness based on liver function in hyperuricemic individuals with hypertension. Sixty-three subjects treated with topiroxostat were grouped according to baseline alanine aminotransferase (ALT) levels (above or below cut-off values of 22, 30, or 40 U/L). The primary endpoint was changes in the cardio-ankle vascular index (CAVI) from baseline to 24 weeks. Significant reductions in CAVI during topiroxostat therapy occurred in subjects with baseline ALT ≥30 U/L or ≥40 U/L, and significant between-group differences were detected. Brachial-ankle pulse wave velocity significantly decreased in the ALT-high groups at all cut-off values. Reductions in morning home blood pressure and serum UA were similar regardless of the baseline ALT level. For eleven subjects with available data, ALT-high groups showed high plasma XOR activity, which was significantly suppressed by topiroxostat. Topiroxostat improved arterial stiffness parameters in hyperuricemic patients with liver dysfunction, which might be related to its inhibitory effect on plasma XOR.

Changes in blood pressure and arterial stiffness monitored using the cardio-ankle vascular index during hemodialysis.

During hemodialysis (HD), blood pressure (BP) changes are frequently observed. However, the mechanism of BP changes during HD has not been fully clarified. The cardio-ankle vascular index (CAVI) reflects the arterial stiffness of the arterial tree from the origin of the aorta to the ankle independent from BP during measurement. Additionally, CAVI reflects functional stiffness in addition to structural stiffness. We aimed to clarify the role of CAVI in regulating the BP system during HD. We included 10 patients undergoing 4-hour HD (total 57 HD sessions). Changes in the CAVI and various hemodynamic parameters were evaluated during each session. During HD, BP decreased and CAVI significantly increased (CAVI, median [interquartile range]; 9.1 [8.4-9.8] [0min] to 9.6 [9.2-10.2] [240min], p < 0.05). Changes in CAVI from 0min to 240min were significantly correlated with water removal rate (WRR) (r = -0.42, p = 0.002). Changes in CAVI at each measurement point were negatively correlated with ΔBP (Δsystolic BPeach MP, r = -0.23, p < 0.0001; Δdiastolic BPeach MP, r = -0.12, p = 0.029). Whereas one patient exhibited a simultaneous decrease in BP and CAVI during the initial 60min of HD. Arterial stiffness monitored with CAVI generally increased during HD. CAVI elevation is associated with decreased WWR and BP. An increase in CAVI during HD may reflect the contraction of smooth muscle cells and play an important role in BP maintenance. Hence, measuring CAVI during HD may distinguish the cause of BP changes.

Acute arterial stiffness responses to on-ball balance exercises in young and middle-aged adults: Role of posture and cumulative effects.

Objective: To examine the acute arterial stiffness changes after maintaining one bout of balance on Swiss ball using different postures in young and middle-aged adults, and to evaluate the cumulative exposure effects on arterial stiffness after multiple exercise bouts in middle-aged adults. Methods: Using crossover design, we first enrolled 22 young adults (24.0 ± 1.1years) and randomized them to non-exercise control (CON), on-ball balance exercise trial lasting 1 × 5min in kneeling posture (K1) and sitting posture (S1). In a following crossover experiment, 19 middle-aged adults (53.0 ± 4.7years) were randomized to non-exercise control (CON), on-ball balance exercise trial lasting 1 × 5min in kneeling posture (K1) and in sitting posture (S1), and on-ball balance exercise trial lasting 2 × 5min in kneeling posture (K2) and in sitting posture (S2). Cardio-ankle vascular index (CAVI), an indicator of systemic arterial stiffness, was measured at baseline (BL), immediately after (0min), and every 10min after exercise. CAVI changes from BL in the same trial (⊿CAVI) were used for analysis. Results: In K1 trial, ⊿CAVI decreased significantly at 0min (p < 0.05) in both young and middle-aged adults; however in S1 trial, ⊿CAVI at 0min increased significantly in young adults (p < 0.05), with ⊿CAVI tending to increase in middle-aged adults. Bonferroni post-test revealed that at 0min, ⊿CAVI of K1 in both young and middle-aged adults, and ⊿CAVI of S1 in young adults differed significantly from that of CON (p < 0.05). In middle-aged adults, ⊿CAVI decreased significantly at 10min compared to BL in K2 trial (p < 0.05), and increased at 0min compared to BL in S2 trial (p < 0.05); however, difference compared to CON was not significant. Conclusion: Single on-ball balance bout in kneeling posture improved arterial stiffness transiently in both young and middle-aged adults; however, sitting posture elicited opposite changes, and this happened only in young adults. Multiple balance bouts resulted in no significant change in arterial stiffness in middle-aged adults.

Validity of Atherosclerotic Calcified Lesions Observed on Low-Dose Computed Tomography and Cardio-Ankle Vascular Index as Surrogate Markers of Atherosclerosis Progression.

The significance of atherosclerotic calcified lesions observed on low-dose computed tomography (LDCT) performed during general checkups was investigated. The coronary arteries (CA), ascending aorta and aortic arch (AAAA), descending thoracic aorta (DTA), and abdominal aorta (AA) were examined. Semiquantitative calcified index analysis of the DTA and AA in terms of atherosclerosis risk factors and cardio-ankle vascular index (CAVI) measurements was also performed. We included 1594 participants (mean age: 59.2years; range: 31-91years). The prevalence of calcified lesions was 71.0%, 66.6%, 57.2%, and 37.9% in the AA, CA, AAAA, and DTA, respectively. Age-related advances in calcification among participants with no major risk factors, revealed that calcification appeared earliest in the AA, followed by the CA, AAAA, and DTA. Participants with calcified lesions in all arteries had a significantly greater CAVI than those without calcification. The CAVI was negatively correlated with low-density lipoprotein cholesterol levels, particularly in participants without calcified lesions in the DTA. Calcified lesions on LDCT could indicate the end stage of atherosclerotic lesions. The CAVI can be used to assess atherosclerotic changes at all stages of disease progression. A combination of LDCT and CAVI could be used as a routine non-invasive assessment of atherosclerosis.

357 - Role of cardio-ankle vascular index as a predictor of left ventricular hypertrophy in children with hypertension

357 - Role of cardio-ankle vascular index as a predictor of left ventricular hypertrophy in children with hypertension

The Relationship Between Cardio-Ankle Vascular Index and Clinical Factors with Aortic Valve Sclerosis in Asymptomatic Patients

Objectives: This study aimed to examine the relationship between aortic valve sclerosis (AVS) and arterial stiffness in asymptomatic individuals without known cardiovascular (CV) disease.Both AVS and arterial stiffness are associated with atherosclerosis and have been closely related to CV diseases in previous studies. In this study, we aimed to examine the relationship between arterial stiffness assessed by CAVI and AVS.&#x0D; Methods: Patients who applied to the cardiology outpatient clinic were included in the study sequentially. Subjects were analyzed according to exclusion criteria.One hundred sixty-five patients were included in the study, and AVS was detected in 35 (21%) of them. The remaining 130 (79%) patients were included in the control group.AVS was measured with echocardiography, and arterial stiffness was measured with the VaSera VS-1000 CAVI device. A CAVI value of 9 and above was accepted as abnormal. Statistics were made according to the group with and without AVS.&#x0D; Results: CAVI was statistically different between the AVS and control groups(9.47±1.64 vs. 7.60±1.27 p&lt; 0.001). The Pearson correlation test determined the correlation between AVS and increased CAVI values (p&lt; 0.001).In the multivariable logistic regression analysis model, increased CAVI (OR: 2.048, 95%CI 1.183-3.547, p: 0.010) was an independent predictor for AVS.Others were found as age (p:0.026) and diabetes mellitus (p:0.037).&#x0D; Conclusions: The relationship between AVS and arterial stiffness is associated with the atherosclerotic process.Careful investigation and regular follow-up of asymptomatic individuals with AVS detected during echocardiography or increased CAVI values are important in other CV diseases.