Relationship between Cardio-Ankle Vascular Index (CAVI) and Carotid Atherosclerosis in Patients with Essential Hypertension

Okura, Takafumi; Watanabe, Sachiko; Kurata, Mie; Manabe, Seiko; Koresawa, Mitsuko; Irita, Jun; Enomoto, Daijiro; Miyoshi, Katsuhiko; Fukuoka, Tatsunari; Higaki, Jitsuo

doi:10.1291/hypres.30.335

Cited by 159 publications

(132 citation statements)

References 31 publications

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“…In general, atherosclerosis involves a combination of fatty degeneration (atherosis) and vessel stiffing (sclerosis). 19 Similarly, the etiology of IHD is mainly coronary atherosclerosis or arteriosclerosis, including atheromatous changes and calcification, and the independent association between coronary artery calcification and cerebral SVD has been reported previously. 8,21 Hence, this association supports the relationship between IHD and SBI in the present study.…”

Section: Discussionmentioning

confidence: 58%

“…8,[19][20][21][22][23] After examinations had been performed on the right and left sides, the lower ankle-brachial pressure index and the higher CAVI were selected for analyses. Ankle-brachial pressure index o0.9 was considered as indicative of peripheral arterial disease.…”

Section: Measurement Of Ankle-brachial Pressure Index and Cavimentioning

confidence: 99%

“…8,[19][20][21][22][23][24] Arterial stiffness, as measured by conventional carotidfemoral pulse wave velocity (PWV) measurement, aortic PWV measurement or non-invasive brachial-ankle PWV (baPWV) measurement, is associated with microvascular early atherosclerotic changes and is an independent predictor for cardiovascular events and deaths. [1][2][3]7,13,14,[25][26][27][28][29] Furthermore, baPWV can be used to assess for the presence of SBI and WMHs.…”

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confidence: 99%

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Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

et al. 2012

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It is still unclear whether silent brain infarct (SBI) and white-matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) scans are associated with cardio-ankle vascular index (CAVI), a novel parameter of arterial stiffness. We studied 220 consecutive patients (mean age, 69 years) without a history of stroke or transient ischemic attack. Patients were assessed for the presence of SBI, WMHs and risk factors. Arterial stiffness was evaluated using CAVI. Patients were categorized into one of two groups according to the presence or absence of SBI and WMHs, and clinical characteristics were compared between the two groups. CAVI was significantly higher in patients with SBI or in patients with WMHs than in those without those respective findings. The CAVI cutoff values for detection of SBI and WMHs were 9.2 and 8.9, respectively. On multivariable analyses, CAVI, a one point increase in CAVI: odds ratio (OR), 1.25; 95% confidence interval (CI), 1.01-1.56; CAVIX9.2: OR, 2.34; 95% CI, 1.16-5.02, was independently associated with SBI, however, CAVI was not independently associated with WMHs. Patients with CAVI X9.2 had higher OR for the presence of both SBI and WMHs (OR, 2.57; 95% CI, 1.15-5.98) when compared with patients with CAVI o9.2 after adjustment for age and sex. SBI is independently associated with arterial stiffness indicated by CAVI.

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Section: Discussionmentioning

confidence: 58%

Section: Measurement Of Ankle-brachial Pressure Index and Cavimentioning

confidence: 99%

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confidence: 99%

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Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

et al. 2012

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“…4 There is now established evidence that aortic stiffness increases with aging and prolonged elevation of blood pressure, 5 and is the underlying pathology of isolated systolic hypertension. 6 Aortic stiffness is closely associated with cerebral large-arterial disease involving the extracranial internal carotid [7][8][9] and intracranial large arteries. 10 It is not possible to study the direct association of aortic stiffness with changes in cerebral microvessels, which cannot be routinely assessed with current imaging technology.…”

Section: Introductionmentioning

confidence: 99%

The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients

et al. 2011

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Large-artery stiffness is a risk factor for stroke, including cerebral small-vessel disease. Retinal microvascular changes are thought to mirror those in cerebral microvessels. We investigated the relationship between aortic stiffness and retinal microvascular changes in Asian ischemic stroke patients. We studied 145 acute ischemic stroke patients in Singapore who had aortic stiffness measurements using carotid-femoral pulse wave velocity (cPWV). Retinal photographs were assessed for retinal microvessel caliber and qualitative signs of focal arteriolar narrowing, arteriovenous nicking and enhanced arteriolar light reflex. Aortic stiffening was associated with retinal arteriolar changes. Retinal arteriolar caliber decreased with increasing cPWV (r ¼ À0.207, P ¼ 0.014).After adjusting for age, gender, hypertension, diabetes, mean arterial pressure and small-vessel stroke subtype, patients within the highest cPWV quartile were more likely to have generalized retinal arteriolar narrowing defined as lowest caliber tertile (odds ratio (OR) 6.84, 95% confidence interval (CI) 1.45-32.30), focal arteriolar narrowing (OR 13.85,), arteriovenous nicking (OR 5.08, CI 1.12-23.00) and enhanced arteriolar light reflex (OR 3.83,), compared with those within the lowest quartile. In ischemic stroke patients, aortic stiffening is associated with retinal arteriolar luminal narrowing as well as features of retinal arteriolosclerosis.

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“…We hypothesize that CBP may reflect cardiac structure and function better than peripheral blood pressure and that it may show a better correlation with cardiac function compared with the cardio-ankle vascular index (CAVI), which has been an established marker of arterial stiffness from the aortic valve to the ankle. [10][11][12] In this study, we examined the associations between CBP and cardiac structure and function by comparing them with those of arterial stiffness assessed by CAVI in treated hypertensive patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of central blood pressure and cardio-ankle vascular index for association with cardiac function in treated hypertensive patients

et al. 2009

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Recent automated applanation tonometry can measure radial pulse wave-derived central blood pressure (CBP), which has shown a prognostic value independently of peripheral blood pressure. However, CBP's clinical significance has not been fully established. We examined the associations between CBP and cardiac structure and function by comparing them with those of arterial stiffness assessed by cardio-ankle vascular index (CAVI) in treated hypertensive patients. Enrolled in the study were 102 patients (71 ± 7 years) with treated hypertension. The transmitral early-to-atrial velocity ratio (E/A), peak systolic (S¢), early diastolic (E¢) mitral annular velocities and the Tei index were measured as indexes of cardiac function derived from conventional and tissue Doppler echocardiography. Left ventricular mass index (LVMI) was measured as an index of LV hypertrophy. CBP and CAVI were measured just after echocardiographic examination. CBP, but not CAVI, correlated with LVMI (r¼0.306, Po0.01). Although CBP correlated only with the Tei index (r¼0.201, Po0.05), CAVI correlated with E/A (r¼À0.387, Po0.001), S¢ (r¼À0.270, Po0.01), E¢ (r¼À0.362, Po0.01) and the Tei index (r¼0.339, Po0.01). Stepwise regression analysis revealed that neither CBP nor CAVI was independently associated with E/A, S¢ or E¢. However, CAVI, but not CBP, was independently associated with the Tei index (b coefficient¼0.311, Po0.001), reflecting both LV systolic and diastolic function. In conclusion, CBP may be suitable for detecting LV hypertrophy. In contrast, CAVI may be suitable for detecting LV dysfunction. This difference, suggesting the clinical value of each parameter, should be kept in mind when we use CBP and CAVI for assessing arteriosclerosis in treated hypertension.

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Relationship between Cardio-Ankle Vascular Index (CAVI) and Carotid Atherosclerosis in Patients with Essential Hypertension

Cited by 159 publications

References 31 publications

Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients

Comparison of central blood pressure and cardio-ankle vascular index for association with cardiac function in treated hypertensive patients

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