Cardio-Ankle Vascular Index Reflects Impaired Exercise Capacity and Predicts Adverse Prognosis in Patients With Heart Failure

Abstract

Aims: We aimed to assess the associations of CAVI with exercise capacity in heart failure (HF) patients. In addition, we further examined their prognosis.Methods: We collected the clinical data of 223 patients who had been hospitalized for decompensated HF and had undergone both CAVI and cardiopulmonary exercise testing.Results: For the prediction of an impaired peak oxygen uptake (VO2) of < 14 mL/kg/min, receiver-operating characteristic curve demonstrated that the cutoff value of CAVI was 8.9. In the multivariate logistic regression analysis for predicting impaired peak VO2, high CAVI was found to be an independent factor (odds ratio 2.343, P = 0.045). We divided these patients based on CAVI: the low-CAVI group (CAVI < 8.9, n = 145) and the high-CAVI group (CAVI ≥ 8.9, n = 78). Patient characteristics and post-discharge cardiac events were compared between the two groups. The high-CAVI group was older (69.0 vs. 58.0 years old, P < 0.001) and had lower body mass index (23.0 vs. 24.1 kg/m2, P = 0.013). During the post-discharge follow-up period of median 1,623 days, 58 cardiac events occurred. The Kaplan–Meier analysis demonstrated that the cardiac event rate was higher in the high-CAVI group than in the low-CAVI group (log–rank P = 0.004). The multivariate Cox proportional hazard analysis revealed that high CAVI was an independent predictor of cardiac events (hazard ratio 1.845, P = 0.035).Conclusion: High CAVI is independently associated with impaired exercise capacity and a high cardiac event rate in HF patients.

Intermittent Hypoxic-Hyperoxic Exposures Effects in Patients with Metabolic Syndrome: Correction of Cardiovascular and Metabolic Profile

“…The arterial stiffness reduction is known to decrease heart afterload and normalize left ventricular diastolic function [45]. The RCAVI and LCAVI shifts dynamics observed were accompanied by the reliable differences in NT-pro-BNP shifts (showing decreasing trends in the IHHE group and increasing trends in control), which can reflect reduction of myocardial stretch from volume overload [46].…”

Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly

“…Finally, in a community-based cohort of older adults, cfPWV was associated with incident HF in partially adjusted models [ 59 ], whereas in asymptomatic patients at risk of HF, an increase in brachial–ankle PWV within 5 years was associated with increased risk of incident HF [ 60 ]. It is noteworthy that an association between AoStiff assessed with CAVI and exercise capacity in patients hospitalized with decompensated HF has also been reported [ 61 ].…”