Cardio-ankle vascular index (CAVI) in diagnostics, risk and severity evaluation of magistral vessels lesion in patients with cardio-vascular diseases and type 2 diabetes

Verner, Vladimir A.; Melnik, Mariya V.; Knjazeva, Svetlana A.

doi:10.26442/00403660.2021.01.200599

Cited by 3 publications

(1 citation statement)

References 68 publications

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“…In these patients, hyperlipidemia and type II diabetes mellitus were significant comorbidities. In addition to accelerating atherosclerosis development, diabetes mellitus affects the characteristic of atherosclerotic lesions in the lower extremities [ 2 , 3 ]. Compared with patients with PAD (peripheral artery disease) and without diabetes mellitus, patients who have PAD and coexisting diabetes mellitus have more arteries below the knee that are affected and more multilevel lesions [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Coronary Syndrome: Disparities of Pathophysiology and Mortality with and without Peripheral Artery Disease

Gherasie

Popescu

Bartos

2023

JPM

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There are a number of devastating complications associated with peripheral artery disease, including limb amputations and acute limb ischemia. Despite the overlap, atherosclerotic diseases have distinct causes that need to be differentiated and managed appropriately. In coronary atherosclerosis, thrombosis is often precipitated by rupture or erosion of fibrous caps around atheromatous plaques, which leads to acute coronary syndrome. Regardless of the extent of atherosclerosis, peripheral artery disease manifests itself as thrombosis. Two-thirds of patients with acute limb ischemia have thrombi associated with insignificant atherosclerosis. A local thrombogenic or remotely embolic basis of critical limb ischemia may be explained by obliterative thrombi in peripheral arteries of patients without coronary artery-like lesions. Studies showed that thrombosis of the above-knee arteries was more commonly due to calcified nodules, which are the least common cause of luminal thrombosis associated with acute coronary events in patients with acute coronary syndrome. Cardiovascular mortality was higher in peripheral artery disease without myocardial infarction/stroke than in myocardial infarction/stroke without peripheral artery disease. The aim of this paper is to gather published data regarding the disparities of acute coronary syndrome with and without peripheral artery disease in terms of pathophysiology and mortality.

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Section: Introductionmentioning

confidence: 99%

Acute Coronary Syndrome: Disparities of Pathophysiology and Mortality with and without Peripheral Artery Disease

Gherasie

Popescu

Bartos

2023

JPM

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Prediction of vascular events in individuals with atherosclerotic lesions of various vascular basins: results of a 3-year prospective follow-up

2022

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Introduction. Today, cardiovascular diseases occupy a leading position in the structure of mortality, both in Russia and throughout the world. Every year more than 17 million people die from cardiac pathology, according to the World Health Organization, an increase in morbidity and mortality is expected in the future, which is explained, first of all, by an increase in the number of patients with diabetes and obesity.Aim. Development of optimal approaches to predicting cardiovascular events and unfavorable outcomes in patients with peripheral atherosclerosis during a 3-year prospective follow-up.Materials and methods. The study included 519 patients with atherosclerotic lesions of various vascular regions, of which 360 (69.4%) were men, 159 (30.6%) were women. The average age of the examined patients was 60.0 ± 8.7 years.Results. In the course of the analysis, it was noted that a factor such as the percentage of table stenosis of the left coronary artery (p = 0.013) influenced the risk of developing non-fatal cases of heart failure in patients with peripheral atherosclerosis. With regard to the end point – fatal cases of heart failure, the following factors demonstrated their statistical significance: age of onset of arterial hypertension, years (p = 0.020); history of chronic heart failure (p = 0.020); left atrial size, mm (p = 0.025); degree of stenosis of the posterior lateral branch, % (p = 0.038); presence of atherosclerotic lesions in the region of the posterior interventricular branch (p = 0.002); number of affected vascular beds (p = 0.044).Conclusions. Using logistic regression equations, original mathematical tools have been developed to assess the risk of developing both fatal and non-fatal heart failure in patients with peripheral atherosclerosis.

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Clinical significance of endocrine disorders in the development of early vascular aging in males with abdominal obesity and concomitant arterial hypertension: An observational cohort study

Ionov,

Kuznetsova,

Kindalyova

et al. 2024

Kuban. nauсh. med. vestnik

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Background. Visceral obesity is a risk factor in the development of metabolic and endocrine disorders leading to arterial hypertension and cardiovascular complications. Their early predictors include increased vascular stiffness and early vascular aging. The current literature lacks studies into the effects of changes in testosterone, cortisol, and aldosterone levels in serum on vascular stiffness and the development of early vascular aging in patients with visceral obesity. Objective. To determine the relationship between hypercortisolemia, hyperaldosteronemia, and hypotestosteronemia and vascular stiffness and the presence of early vascular aging in male patients with visceral obesity. Methods. An observational cohort study of 78 males aged 35–45 years (mean age 38.1 ± 6.5 years) diagnosed with abdominal obesity and grade 1 arterial hypertension was conducted. The mean waist circumference ranged 105.5 ± 6.9 cm; systolic and diastolic blood pressure ranged 152.5 ± 5.0 and 92.5 ± 5.0 mm Hg, respectively. The vascular age of the studied patients (n = 78) comprised 44.1 ± 6.2 years, which was statistically higher than their passport age (р < 0.001). The studied patients were divided into subgroups according to both total testosterone (< 12.1 nmol/l in subgroup 1A (n = 49) and ≥ 12.1 nmol/L in subgroup 1B (n = 29)) and cortisol in the evening saliva portion (> 4.5 nmol/L in subgroup 2A (n = 24) and ≤ 4.5 nmol/L in subgroup 2B (n = 24)). All the patients completed the study. To assess the hormonal status, the total testosterone sex steroid-binding globulin (SSBP) and insulin in morning serum samples were investigated. Insulin resistance was assessed based on the NOMA-IR index. The concentration of total testosterone was determined by enhanced chemiluminescence (Ortho-Clinical Diagnostics, J&J); the SSBP and insulin levels were determined by delayed fluorescence. Aldosterone content was determined by radioimmunoassay; free cortisol and testosterone were measured by luminescent LIA. Free and bioavailable testosterone concentrations in serum were calculated using an online calculator (issam.ch/freetesto.htm). The cardio-ankle vascular index (CAVI) was determined using a VaSera VS-15000N device, which automatically calculated the vascular age. Statistical analysis was performed using the Statistica 10.0 Windows package (StatSoft, Inc., USA). Results. The vascular age of patients with hypogonadism was statistically significantly ( р < 0.001) higher than their passport age and the vascular age in males without hypogonadism. The CAVI and vascular age were also statistically significantly higher in males with functional hypercorticism (р < 0.001) compared with a subgroup of patients without hypercorticism. The vascular age and CAVI increased with an increase in the salivary cortisol concentration 2200 (r = 0.5; р < 0.05) and decreased with an increase in the salivary cortisol level 900 (r = –0.5; р < 0.05). These parameters decreased with an increase in serum aldosterone obtained in the morning (r = –0.4; p < 0.05) and increased with an increase in serum aldosterone in the evening (r = 0.4; p < 0.05). In 23% (n = 18), an inversion of the daily rhythm of cortisol production was observed; in these patients, salivary cortisol levels of 2200 exceeded salivary cortisol levels of 900. The vascular age of patients with the inversion of cortisol production (49.4 ± 4.4 years) was statistically significantly ( р < 0.001) different from that of patients with normal changes in salivary cortisol concentrations (41.9 ± 4.9 years). CAVI was also higher (р < 0.001) in males with inverted fluctuations in salivary cortisol levels (7.51 ± 0.62) compared to those with normal diurnal rhythm (6.45 ± 0.69). The results of aldosterone evaluation revealed that 17% of the patients (n = 13) had higher aldosterone levels in the evening serum portion compared to the morning serum portion. In these patients, the vascular age (45.8 ± 5.1 years) was higher ( р < 0.001) than that in males with normal physiologic changes in aldosterone levels (41.6 ± 5.7 years). A similar pattern was observed when comparing vascular stiffness indices. Thus, the CAVI in men with inverted changes in aldosterone concentration (6.9 ± 0.8) was significantly higher ( р < 0.001), compared to that in men with physiological changes in blood aldosterone levels (6.4 ± 0.8). Conclusion. Endocrinologic disorders in male patients with visceral obesity and concomitant arterial hypertension (functional hypogonadism, functional hypercorticism, inverted daily rhythms of cortisol and aldosterone production) contribute to the development of early vascular aging by increasing vascular stiffness.

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Cardio-ankle vascular index (CAVI) in diagnostics, risk and severity evaluation of magistral vessels lesion in patients with cardio-vascular diseases and type 2 diabetes

Cited by 3 publications

References 68 publications

Acute Coronary Syndrome: Disparities of Pathophysiology and Mortality with and without Peripheral Artery Disease

Acute Coronary Syndrome: Disparities of Pathophysiology and Mortality with and without Peripheral Artery Disease

Prediction of vascular events in individuals with atherosclerotic lesions of various vascular basins: results of a 3-year prospective follow-up

Clinical significance of endocrine disorders in the development of early vascular aging in males with abdominal obesity and concomitant arterial hypertension: An observational cohort study

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