Aim:The cardio-ankle vascular index (CAVI) has been proposed as a new noninvasive marker of arterial stiffness independent of blood pressure. We investigated the association of the CAVI with coronary atherosclerosis and left ventricular (LV) systolic and diastolic function in patients with ischemic heart disease (IHD).

The present study revealed that an increased CAVI was independently associated with LV diastolic dysfunction in patients with preserved systolic function.

Objective: The augmentation index, a marker of wave reflection, has been reported to reflect vascular properties and to determine left ventricular (LV) characteristics. We investigated the relationship between the augmentation index and paroxysmal atrial fibrillation (AF). Methods: A total of 244 outpatients (122 patients with paroxysmal AF and 122 age-, and gender-matched controls without paroxysmal AF) were examined during sinus rhythm. The augmentation index was calculated from the radial arterial waveform using applanation tonometry methods. Results: After adjusting for age, gender, heart rate, and medications, the augmentation index was significantly higher in patients with paroxysmal AF than in subjects without paroxysmal AF (means ± SE: 88.9 ± 1.0 and 81.8 ± 1.0%, respectively; p < 0.001). In all subjects, an increase in the augmentation index was significantly correlated with LV hypertrophy and left atrial enlargement. Multiple logistic analysis revealed that an increase in the augmentation index was significantly related with paroxysmal AF, and the adjusted odds ratio of paroxysmal AF was approximately 1.8 for each 10% augmentation index increase (p < 0.01). Conclusion: An increase in the augmentation index was independently associated with paroxysmal AF. This result suggests that enhanced wave reflection may be related to the development of AF.

B-type natriuretic peptide (BNP) levels have been shown to be elevated in patients with paroxysmal atrial fibrillation (PAF); however, the underlying mechanisms have not been fully elucidated. Earlier, we reported that an increase in the augmentation index (AI), which is an index of wave reflection and arterial stiffness, is associated with PAF. In this study, we investigate the relationship between the BNP level and AI in patients with PAF. We enrolled 92 patients with a history of PAF and 90 age-and gender-matched individuals without PAF. AI was calculated using applanation tonometry of the radial artery when all patients were on sinus rhythm. Plasma BNP levels were measured simultaneously. An arterial stiffness parameter, the cardio-ankle vascular index (CAVI), was also evaluated. The increased AI in patients with PAF correlated with the elevation of the BNP level (r¼0.47, Po0.01). When PAF patients were classified into tertiles on the basis of the BNP level, the left atrial volume index, left ventricular mass index, AI and CAVI increased, and mitral annular e¢ velocity (e¢), as an index of left ventricular diastolic pressure, decreased with BNP tertiles. AI was also associated with e¢ and left ventricular mass index. Multiple regression analysis showed that the AI in PAF patients independently correlated with BNP levels. This study showed that AI was an independent correlate of the BNP level in PAF patients. Left ventricular diastolic dysfunction, which linked to an increase in arterial stiffness, may be involved in the elevated BNP level. INTRODUCTIONThe B-type natriuretic peptide (BNP) is a neurohormone secreted from cardiac ventricles in response to ventricular volume and pressure overload. 1 The BNP level does not only significantly correlate with the left ventricular (LV) filling pressure but also reflects symptomatic LV dysfunction and prognosis. 2 Although BNP has been reported to be an excellent screening tool for LV dysfunction, some patients with paroxysmal atrial fibrillation (PAF) or coronary artery disease have been shown to have a high BNP level, independent of LV systolic function; 3,4 however, the underlying mechanisms of the increase in BNP level in patients with PAF have not been fully elucidated.Our recent study showed that the augmentation index (AI) obtained from the radial artery is increased in patients with PAF. 5 AI, determined from either a directly measured or derived central arterial pressure wave form, has been proposed as a measure of aortic stiffness and wave reflection. 6 Earlier studies have shown that AI is closely related to several risk factors for atherosclerosis 7 and cardiovascular diseases. 8 AI can be determined noninvasively by pulse wave

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