Establishment of the Cardio-Ankle Vascular Index in Patients With Obstructive Sleep Apnea

Kumagai, Takiko; Kasai, Takatoshi; Kato, Megumi; Naito, Ryo; Maeno, Ken-ichi; Kasagi, Satoshi; Kawana, Fusae; Ishiwata, Sugao; Narui, Koji

doi:10.1378/chest.09-0178

Cited by 38 publications

(38 citation statements)

References 29 publications

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“…50 This conclusion is strengthened by the findings of Tomiyama et al, 51 who found AHI to be an independent predictor of baPWV. Furthermore, Kumagai et al 52 compared patients with mild and moderate to severe OSA using the cardio-ankle vascular index. They found cardio-ankle vascular index to be lower in patients with mild OSA as compared to patients with moderate to severe OSA.…”

Section: Resultsmentioning

confidence: 99%

“…Out of the seven studies investigating the association between severity of OSA and arterial stiffness, 45,47,48,51,52,60,62 six provided full support for the association 45,47,51,52,60,62 and one provided mixed results. 48 More specifically, the study by Protogerou et al 48 did not find a direct association between OSA severity categories (moderate, severe and very severe) and arterial stiffness.…”

Section: Discussionmentioning

confidence: 99%

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Increased arterial stiffness in obstructive sleep apnea: a systematic review

et al. 2010

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Obstructive sleep apnea is a prevalent disease that is associated with significant morbidity and mortality, particularly due to cardiovascular disease. An emerging cardiovascular risk factor, arterial stiffness, may also be involved in the cardiovascular complications of obstructive sleep apnea. The purpose of this review was to summarize the current literature regarding the effect of obstructive sleep apnea on arterial stiffness. We conducted a systematic literature review using PubMed, Embase and the Cochrane Library. We identified 24 studies that met search criteria investigating the effect of obstructive sleep apnea on arterial stiffness. Arterial stiffness was found to be increased in obstructive sleep apnea patients compared with controls or increased in severe compared with mild sleep apnea. In some studies, a positive correlation was identified between the degree of arterial stiffness and sleep apnea severity. In the two randomized, controlled trials and the two nonrandomized trials identified, treatment of obstructive sleep apnea with continuous positive airway pressure led to significant decreases in arterial stiffness. Obstructive sleep apnea appears to have an independent effect on arterial stiffness, which may be one of the mechanisms accounting for sleep apnea-associated cardiovascular risk.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Increased arterial stiffness in obstructive sleep apnea: a systematic review

et al. 2010

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“…Izuhara et al 25) reported that CAVI is indepen- , Izuhara 25) , Miyoshi 26) , Horinaka 27) [Sairaku 29) ] Intima media thickness of cervical artery Nakamura 24) , Ibata 22) , Takaki 20,28) , Izuhara 25) , Miyoshi 26) , Okura 36) , Sairaku 29) , Horinaka 27) , Hayashi 38) Chronic kidney disease [Mortality rate in patients with hemodialysis] Izuhara 25) , Kobuzono 30) , Takenaka 31) , Nakamura 32) , Ueyama 33) , Satoh-Asahara 36) [Kato 40) ] Cerebral infarction, Dementia Yamamoto 39) Metabolic syndrome Satoh 55) Diabetes mellitus Ibata 22) , Izuhara 25) , Okura 37) Hypertension Kubozono 21) , Okura 37) , Takaki 42) , Kadota 43) Dyslipidemia Takaki 28) Smoking Kubozono 21) , Noike 62) Obstructive sleep apnea syndrome Kumagai 60) dently associated with the severity of coronary atherosclerosis. Recently, Miyoshi et al 26) also supported a correlation between CAVI and coronary atherosclerosis.…”

Section: A Coronary Artery Diseaseunclassified

Cardio-Ankle Vascular Index (CAVI) as a Novel Indicator of Arterial Stiffness: Theory, Evidence and Perspectives

Shirai

Hiruta

Song

et al. 2011

J Atheroscler Thromb

395

426

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The cardio-ankle vascular index (CAVI) is a new index of the overall stiffness of the artery from the origin of the aorta to the ankle. The most conspicuous feature of CAVI is its independence of blood pressure at the time of measurement. CAVI increases with age and in many arteriosclerotic diseases, such as coronary artery disease, carotid arteriosclerosis, chronic kidney disease and cerebrovascular disease, and is related to many coronary risk factors, such as hypertension, diabetes mellitus, dyslipidemia and smoking. Furthermore, CAVI decreases by controlling diabetes mellitus and hypertension, and also by abstaining from smoking. This suggests that CAVI is a physiological surrogate marker of athero-or arteriosclerosis, and also might be an indicator of lifestyle modification. Recently, it has been reported that CAVI and several left ventricular functions are co-related, suggesting a connection between the heart muscle and vascular function. This review covers the principles of CAVI and our current knowledge about CAVI, focusing on its roles and future outlook. J Atheroscler Thromb, 2011; 18:924-938.

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“…For example, the CAVI changes over a short period of time in response to alterations in circulatory conditions, reflecting the state of smooth muscle contractions, rather than changes in blood pressure 37) . Moreover, the CAVI is not related to systolic or diastolic blood pressure 17,36) ; therefore, it is considered to be superior to PWV as an index of arterial stiffness.…”

Section: Resultsmentioning

confidence: 99%

“…It has also been shown that short-term weight reduction therapy improves not only metabolic dysfunction, but also the severity of OSA and arterial stiffness, as measured by CAVI 16) . The measurement of CAVI has demonstrated good reproducibility and was not affected by the blood pressure during measurement 17,18) . To date, the majority of studies linking OSA to arterial stiffness recruited participants from sleep clinic patients [19][20][21] , there have been only two communitybased studies 22,23) , which also recruited patients with sleep disorder breathing and their methodology to measure arterial stiffness was different to CAVI.…”

Section: Assessment Of Nihmentioning

confidence: 95%

Relationships between Nocturnal Intermittent Hypoxia, Arterial Stiffness and Cardiovascular Risk Factors in a Community-based Population: The Toon Health Study

Alberto

Tanigawa

Maruyama

et al. 2014

JAT

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Aim: Nocturnal intermittent hypoxia (NIH), a primary marker of obstructive sleep apnea, has increasingly been linked with cardiovascular morbidity and mortality. The purpose of this study was to investigate the association between NIH and arterial stiffness as measured according to the cardio-ankle vascular index (CAVI) based on cardiovascular risk factors in a Japanese community-dwelling population. Methods: We conducted a cross-sectional study in Toon city among 684 men and 1,241 women 30-79 years of age. The severity of NIH was defined as mild or moderate-to-severe according to five or 15 events/hour on the 3% oxygen desaturation index (ODI), respectively. Increased arterial stiffness was diagnosed according to a CAVI of ≥ 9. Results: The number of subjects with no, mild and moderate-to-severe NIH was 1,348 (70%), 451 (23%) and 126 (7%), respectively. Increased arterial stiffness was detected in 21.9% of the participants. The multivariable-adjusted odds ratio (95% CI) of severe NIH related to an increased CAVI in comparison with a 3% ODI of ＜5 was 1.36 (0.82-2.23). The stratified logistic regression analysis showed that the multivariable-adjusted OR of severe NIH for an increased CAVI was remarkably increased in the individuals with a BMI of ≥ 25 (OR = 2.53, 1.08-5.96; p = 0.03). An interaction test showed a trend for an overweight status to be a modifier of the association between OSA and increased arterial stiffness (p = 0.05). Conclusions: NIH has a tendency to promote increased arterial stiffness as measured according to the CAVI, especially in overweight subjects.

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Establishment of the Cardio-Ankle Vascular Index in Patients With Obstructive Sleep Apnea

Cited by 38 publications

References 29 publications

Increased arterial stiffness in obstructive sleep apnea: a systematic review

Increased arterial stiffness in obstructive sleep apnea: a systematic review

Cardio-Ankle Vascular Index (CAVI) as a Novel Indicator of Arterial Stiffness: Theory, Evidence and Perspectives

Relationships between Nocturnal Intermittent Hypoxia, Arterial Stiffness and Cardiovascular Risk Factors in a Community-based Population: The Toon Health Study

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