New Horizons of Arterial Stiffness Developed Using Cardio-Ankle Vascular Index (CAVI)

Abstract

Arterial stiffness is recognized mainly as an indicator of arteriosclerosis and a predictor of cardiovascular events. Cardio-ankle vascular index (CAVI), which reflects arterial stiffness from the origin of the aorta to the ankle, was developed in 2004. An important feature of this index is the independency from blood pressure at the time of measurement. A large volume of clinical evidence obtained using CAVI has been reported. CAVI is high in patients with various atherosclerotic diseases including coronary artery disease and chronic kidney disease. Most coronary risk factors increase CAVI and their improvement reduces CAVI. Many prospective studies have investigated the association between CAVI and future cardiovascular disease (CVD), and proposed CAVI of 9 as the optimal cutoff value for predicting CVD. Research also shows that CAVI reflects afterload and left ventricular diastolic dysfunction in patients with heart failure. Furthermore, relatively acute changes in CAVI are observed under various pathophysiological conditions including mental stress, septic shock and congestive heart failure, and in pharmacological studies. CAVI seems to reflect not only structural stiffness but also functional stiffness involved in acute vascular functions. In 2016, Spronck and colleagues proposed a variant index CAVI0, and claimed that CAVI0 was truly independent of blood pressure while CAVI was not. This argument was settled, and the independence of CAVI from blood pressure was reaffirmed. In this review, we summarize the recently accumulated evidence of CAVI, focusing on the proposed cutoff values for CVD events, and suggest the development of new horizons of vascular function index using CAVI. appropriate in studies that examine the effect of hypertension or the effect of antihypertensive drugs on intrinsic arterial stiffness. To overcome this problem, Hayashi 4) proposed the stiffness parameter , an index reflecting arterial stiffness of local arterial segment, which is not influenced by blood pressure at the time of measurement. Subsequently, this theory has been applied to a new arterial stiffness index called cardio-ankle vascular index (CAVI) developed in 2004 5) , and this index reflects the stiffness of the arterial tree from the origin of the aorta to the ankle. The CAVI equation was essentially derived from the stiffness parameter , and the changes of the artery caliber in the equation during the cardiac cycle were obtained Copyright©2020 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

CAVI-Lowering Effect of Pitavastatin May Be Involved in the Prevention of Cardiovascular Disease: Subgroup Analysis of the TOHO-LIP

“…Arterial stiffness is mainly recognized as an indicator of arteriosclerosis and a predictor of CV events. Cardio-ankle vascular index (CAVI) is a new arterial stiffness index, and the equation is essentially derived from the stiffness parameter 14,15) . Therefore, CAVI is independent of blood pressure at the time of measurement 16) and indicates the intrinsic stiffness of the aortic wall.…”

“…Therefore, CAVI is independent of blood pressure at the time of measurement 16) and indicates the intrinsic stiffness of the aortic wall. Increased CAVI is observed in persons with CVD and risk factors such as dyslipidemia, and the improvement of risk factors reduces CAVI 15,17) . Miyashita et al 18) reported that pitavastatin treatment significantly decreased CAVI, as well as marker of between groups, and the incidence of 3P-MACE [pitavastatin, 1.6% (n 2); atorvastatin, 6.1% (n 8); P 0.038] (Fig.…”

“…Clinical trials have shown that individuals with elevated low-density lipoprotein cholesterol (LDL-C) are at increased risk of cardiovascular disease (CVD), and LDL-C reduction with statin therapy reduces oxidative stress in patients with type 2 diabetes. Furthermore, many prospective studies have revealed that CAVI predicts future CV events 15,19) . Therefore, in the context of TOHO-LIP, we are keenly interested in whether pitavastatin lowers CAVI and whether the change in CAVI is associated with CV events.…”

Effects of Active Learning Education on Arterial Stiffness of Older Adults with Low Health Literacy: A Randomized Controlled Trial

“…CAVI has been used in clinical settings and recognized as a strong predictor of cardiovascular events 36) . Otsuka and colleagues 5) investigated changes in CAVI after management of atherosclerotic risk factors and whether these changes influenced the incidence of future cardiovascular events in patients with coronary artery disease (mean age 65 years).…”

Basic Research Sheds Light on the Aspect of Cardio-Ankle Vascular Index (CAVI) including Elastic and Muscular Arteries

“…A recent review article published in the Journal of Atherosclerosis and Thrombosis summarized that CAVI is associated with the presence of atherosclerotic diseases including coronary artery disease, cerebral infarction, chronic kidney disease, and thickening of the carotid intima-media thickness, and coronary risk factors, such as hypertension, diabetes mellitus, uric acid disorders, sleep apnea syndrome, smoking, and obesity in several cross-sectional studies 3) . In addition, several prospective studies demonstrated that CAVI is a predictor of cardiovascular outcomes 3) including that CAVI is an independent long-term predictor of major adverse cardiovascular events, particularly cardiovascu-lar death, in patients with acute coronary syndrome 4) . Moreover, high CAVI (cut-off point of ≥ 9) was reported to be independently associated with a rapid decline in glomerular filtration rate in patients at high risk of cardiovascular disease with or without chronic kidney disease, which suggested that systemic vascular stiffness predicted a decrease in renal function in this population 5) .…”