Comparison of Predictive Ability of Arterial Stiffness Parameters Including Cardio-Ankle Vascular Index, Pulse Wave Velocity and Cardio-Ankle Vascular Index0

Abstract

Cardio-ankle vascular index (CAVI) was developed to reflect the stiffness of the arterial tree from the aortic origin to the ankle. This arterial stiffness parameter is useful for assessing the severity of cardiovascular disease (CVD) and its risk. However, compared to pulse wave velocity (PWV), the conventional gold standard of arterial stiffness parameter, there has been a concern regarding CAVI that there are fewer longitudinal studies for CVD. Furthermore, the accuracy of CAVI for atherosclerotic diseases compared to other parameters has not been well validated. This review article aims to summarize recent findings to clarify the predictive ability of CAVI in longitudinal studies. First, several large longitudinal studies have found that not only baseline CAVI but also CAVI changes during the observation period predict cardiovascular events. Second, CAVI may have superior discriminatory power for all-cause mortality and major adverse cardiovascular endpoints compared to PWV. Furthermore, one large longitudinal study found CAVI to be a stronger predictor for renal function decline compared to PWV as well as CAVI 0 , a variant of CAVI that mathematically excludes BP dependence. Additionally, CAVI shows the properties that allow the elucidation of specific hemodynamics in aortic valve disease or hypovolemia. In conclusion, CAVI may be a modifiable arterial stiffness parameter not only for predicting and preventing atherosclerotic diseases but also for elucidating specific hemodynamic pathophysiology.

Dynamics of the State of Arterial Stiffness as a Possible Pathophysiological Factor of Unfavorable Long-Term Prognosis in Patients after Coronary Artery Bypass Grafting

“…Considering the adverse effect of stress on arterial stiffness, which mediates the development of MACE, another direction in the treatment of such patients may be behavioral therapy. Currently, there are no studies examining the effect of stress-limiting therapy on improving vascular function, as already noted [27]. Accordingly, future research is needed to determine whether stress-reducing behavioral interventions can lead to reductions in cardiovascular events through improvements in CAVI.…”

Association of COVID-19 and Arterial Stiffness Assessed using Cardiovascular Index (CAVI)

“…Experts highlight the clinical value of CAVI as a predictor of hypertension, cardiovascular diseases, kidney injury progression, cognitive decline and dementia, and cardiovascular and total mortality [ 59 ]. Furthermore, there is data that CAVI may be superior in predicting all-cause mortality, major cardiovascular outcomes and renal function decline compared to PWV [ 60 ]. The study of the validity of atherosclerotic calcified lesions demonstrated that CAVI can be used to assess atherosclerotic changes at all stages of disease progression [ 61 ].…”

The effects of severe periodontitis on arterial stiffness using cardio‐ankle vascular index in patients with type 2 diabetes

“…19 Longitudinal studies have been reported that CAVI is a superior technique than pulse wave velocity (PWV) to determine the severity of coronary artery disease. 20 It has been stated that CAVI improves with the control of diseases which accelerate the atherosclerosis such as diabetes and hypertension. 19 Studies have found that a significant relationship between the severe periodontitis and increased CAVI values.…”

“…CAVI measurements increases with age and is high even in mild atherosclerotic disease 19 . Longitudinal studies have been reported that CAVI is a superior technique than pulse wave velocity (PWV) to determine the severity of coronary artery disease 20 . It has been stated that CAVI improves with the control of diseases which accelerate the atherosclerosis such as diabetes and hypertension 19 …”