Brachio-ankle pulse wave velocity and cardio-ankle vascular index (CAVI)

Yambe, Tomoyuki; Yoshizawa, Makoto; Saijo, Yoshifumi; Yamaguchi, Tasuku; Shibata, Masateru; Konno, Satoshi; Nitta, S.; Kuwayama, Takashi

doi:10.1016/s0753-3322(04)80015-5

Cited by 168 publications

(159 citation statements)

References 14 publications

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“…The principal underlying CAVI has been described. 24,25 ECG electrodes were placed on both wrists, a microphone to detect heart sounds was placed on the sternum, and cuffs were wrapped around both arms and both ankles. After automatic measurements, the obtained data were analyzed using VSS-10 software (Fukuda Denshi), and the right and left CAVI values were calculated.…”

Section: Echocardiographic Examinationmentioning

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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Section: Echocardiographic Examinationmentioning

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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“…PWV was calculated by dividing the distance from the aortic valve to the ankle artery by the sum of the difference between the time the pulse waves were transmitted to the brachium and the time the same waves were transmitted to the ankle, and the time difference between the second heart sound on the phonocardiogram and the notch of the brachial pulse waves. [15][16][17] To minimize cuff inflation effects on blood flow dynamics, pulse waves were measured with the cuffs inflated to lower than diastolic pressure (50 mm Hg). The extremity blood pressure was then measured by oscillometry.…”

Section: Measurements Of Bapwv and Cavimentioning

confidence: 99%

“…CAVI is adjusted for BP based on the stiffness parameter b and therefore measures arterial stiffness independent of BP. [15][16][17] We have reported previously that CAVI showed a weaker correlation with systolic BP (SBP) than baPWV and was not affected by changes in BP during measurement. 9 There is also evidence that CAVI reflects histological arterial fibrosis and is a useful clinical marker for evaluating arterial stiffness in HD patients.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive indices of arterial stiffness in hemodialysis patients

et al. 2009

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The purpose of this study was to evaluate the validity of brachial-ankle pulse wave velocity (baPWV) and the cardio-ankle vascular index (CAVI) as measures of arterial stiffness in hemodialysis (HD) patients. We studied 160 consecutively enrolled HD patients (mean age: 59±13 years; 91 male patients). We measured baPWV and CAVI using a VaSera VS-1000, maximum intima-media thickness (max IMT) of the carotid artery by ultrasonography and blood renal and lipid parameters. As a control, baPWV and CAVI were also measured in age-and gender-matched healthy volunteers. Both baPWV and CAVI were significantly higher in HD patients than in controls (baPWV: 1698 ± 355 vs. 1454 ± 263 cm s À1 , Po0.0001; CAVI: 9.3 ± 1.4 vs. 8.9 ± 1.2, Po0.01). BaPWV correlated positively with age (r ¼0.549, Po0.0001), systolic blood pressure (SBP) (r¼0.510, Po0.0001), diastolic blood pressure (r ¼0.203, Po0.0001), pulse pressure (PP) (r ¼0.499, Po0.0001), Kt V À1 (r ¼0.221, Po0.01), Brinkman index (r ¼0.186, Po0.05) and max IMT (r ¼0.285, Po0.001). CAVI also correlated positively with age (r ¼0.562, Po0.0001), SBP (r ¼0.395, Po0.0001), PP (r ¼0.490, Po0.0001), Kt V À1 (r ¼0.216, Po0.01), Brinkman index (r ¼0.238, Po0.01) and max IMT (r ¼0.280, Po0.001). Multiple regression analysis demonstrated baPWV and CAVI correlated independently with age and SBP. Receiver operating characteristics (ROC) curve analysis demonstrated that baPWV and CAVI had similar power to predict increases in max IMT. We also measured baPWV and CAVI immediately before and after HD, and showed CAVI was influenced by changes in water volume. Both baPWV and CAVI are therefore useful indices of arterial stiffness in HD patients.

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“…The principal underlying CAVI has been described previously (Yambe et al 2004;Yambe et al 2005;Shirai et al 2006). ECG electrodes were placed on both wrists, a microphone for detecting heart sounds was placed on the sternum, and cuffs were wrapped around both arms and both ankles.…”

Section: Measurement Of Cavimentioning

confidence: 99%

“…Recently, the cardio-ankle vascular index (CAVI) has been used to assess arterial stiffening instead of pulse wave velocity because it is less influenced by blood pressure than pulse wave velocity (Yambe et al 2004;Yambe et al 2005;Shirai et al 2006). On the other hand, left ventricular (LV) diastolic dysfunction detected via a decreased transmitral early-to-late flow velocity ratio (E/A ratio) is also known to be a marker for increased risk of cardiovascular events (Schillaci et al 2002;Redfield et al 2003).…”

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confidence: 99%