Physical Function and Cardio-Ankle Vascular Index in Elderly Heart Failure Patients

Ogawa, Aiko; Shimizu, Kazuhiro; Nakagami, Takahiro; Mikami, Hiroshi; Shirai, Kohji

doi:10.1536/ihj.20-058

Cited by 11 publications

(14 citation statements)

References 36 publications

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“…There was weak association between CAVI and exercise capacity in the present study. Concordant with our data, it has recently been reported that CAVI was associated with 6min walk test, and indicated that arterial stiffness may relate to partly exercise capacity (17). Regarding arterial stiffness and impaired exercise capacity in HF patients, abnormal ventriculararterial coupling may be caused by vascular dysfunction in HF (4).…”

Section: Discussionsupporting

confidence: 91%

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

Watanabe

Yoshihisa

Sato

et al. 2021

Front. Cardiovasc. Med.

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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.

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Section: Discussionsupporting

confidence: 91%

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

Watanabe

Yoshihisa

Sato

et al. 2021

Front. Cardiovasc. Med.

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“…CAVI, cardio-ankle vascular index; CV, cardiovascular; CAD, coronary artery disease; CVD, cardiovascular disease; NRI, net reclassification improvement; MI, myocardial infarction; HR, hazard ratio; ACS, acute coronary syndrome; OR, odds ratio; SD, standard deviation; MACE, major adverse cardiovascular events; GRACE, global registry for acute coronary events CAVI may also improve LV function and prevent heart failure. Recently, Ogawa et al 109) reported that CAVI and physical function assessed by 6-minute walk distance are complementary to each other in elderly heart failure patients. Development of new cardiac rehabilitation by monitoring CAVI is anticipated.…”

Section: 8mentioning

confidence: 99%

“…Since the LV function and morphology are closely related to arterial stiffness, treatments that improve CAVI may also improve LV function and prevent heart failure. Recently, Ogawa et al 109 ) reported that CAVI and physical function assessed by 6-minute walk distance are complementary to each other in elderly heart failure patients. Development of new cardiac rehabilitation by monitoring CAVI is anticipated.…”

Section: The Possible Role Of Cavi In Cardio-vascular Interactionmentioning

confidence: 99%

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

Saiki

Ohira

Yamaguchi

et al. 2020

JAT

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105

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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.

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“…11) For assessing the reproducibility of 3D echo quantification of mitral leaflet size and coaptationzone areas, two independent observers performed 3D echocardiographic measurements, and one observer repeated the measurements subsequently in 10 cases. Cardio-ankle vascular index: CAVI was measured by the VS2000 system (Fukuda Denshi, Tokyo) for assessing atherosclerosis 18,19) at the discretion of the attending physician. The mean CAVI was calculated as the average of right and left CAVI.…”

Section: Study Subjectsmentioning

confidence: 99%

“…17) In a previous study, 11) we found that some atherosclerosis-related risk factors were associated with mitral leaflet size and coaptation. We hypothesized that the cardio-ankle vascular index (CAVI), which is widely used for assessing atherosclerosis comprehensively, 18,19) may be associated with MV leaflet size. The aim of this study was to determine the association between the MV leaflet and coaptation-zone areas and the degree of atherosclerosis as assessed by CAVI 18,19) or other clinical factors in patients with normal LV systolic function and size by real-time 3-dimensional echocardiography (RT3DE).…”

mentioning

confidence: 99%

Mitral Valvular Coaptation-Zone Area Is Associated with the Severity of Atherosclerosis Assessed by Cardio-Ankle Vascular Index

Kawata

Nakao

et al. 2021

Int. Heart J.

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Preservation of the mitral valve (MV) size is essential for valve function, and a reduced MV coaptationzone area increases the risk of developing functional mitral regurgitation (FMR). We aimed to determine if the MV leaflet and coaptation-zone areas were associated with the severity of atherosclerosis assessed by cardioankle vascular index (CAVI) in patients with normal left ventricle (LV) systolic function and size by real-time 3 D echocardiography (RT3DE).We performed RT3DE analysis in 66 patients with normal LV size and ejection fraction who underwent 2 D echocardiography and CAVI. MV coaptation-zone areas were measured by custom 3D software and indexed by body surface area (BSA). The associations of clinical factors and mean CAVI with MV leaflet and coaptation-zone areas were evaluated by univariable and multivariable linear regression analyses.On univariable analysis, MV leaflet area/BSA was significantly associated with age (r = −0.335, P = 0.0069

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Physical Function and Cardio-Ankle Vascular Index in Elderly Heart Failure Patients

Cited by 11 publications

References 36 publications

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

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

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

Mitral Valvular Coaptation-Zone Area Is Associated with the Severity of Atherosclerosis Assessed by Cardio-Ankle Vascular Index

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