Predictive Ability of Pressure-Corrected Arterial Stiffness Indices: Comparison of Pulse Wave Velocity, Cardio-Ankle Vascular Index (CAVI), and CAVI0

Spronck, Bart; Obeid, Mary Jo; Paravathaneni, Mahati; Gadela, Naga Vaishnavi; Singh, Gurpreet K; Magro, Caroline; Kulkarni, Varsha; Kondaveety, Soumya; Gade, Keerthi Chandrika; Bhuva, Rushik; Kulick-Soper, Colin M; Sanchez, Nicolas; Akers, Scott; Chirinos, Julio A.

doi:10.1093/ajh/hpab168

Cited by 14 publications

(7 citation statements)

References 40 publications

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“…Our study moves from the assumption that CAVI is a valid estimate of arterial stiffening in older ages [25]. Although guidelines endorse the use of cfPWV as the gold standard for arterial stiffness evaluation [3], there has been increasing interest in CAVI and CAVI0 [26]. As compared to cfPWV, which is a particular measurement of the central aortic segments, CAVI is known to be representative of a wider proportion of the arterial tree, including both central and peripheral segments [13].…”

Section: Discussionmentioning

confidence: 99%

Cardio-Ankle Vascular Index and Aging: Differences between CAVI and CAVI0

Giani,

Micciolo,

Zoico

et al. 2023

JCM

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Background: Cardio-ankle vascular index (CAVI) and CAVI0 (a mathematical expression derived from CAVI, supposed to be less dependent on blood pressure), can describe arterial stiffness, considering a wide proportion of the arterial tree. The aim of this study was to examine the relationship between CAVI, CAVI0 and aging, looking at the differences between the two arterial stiffness indexes. Methods: A total of 191 patients (68 male, mean age 68.3 ± 14.4 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included and underwent a comprehensive clinical evaluation. CAVI and CAVI0 were obtained for each. Results: CAVI0 steeply rises in the elderly age strata, widening the gap between CAVI and CAVI0. An inverse relationship is evident between CAVI0 and DBP in older patients, and CAVI0 is shown to be dependent on age, DBP and age-DBP interaction (R2 = 0.508). Age modifies the effect of DBP on CAVI0, but not on CAVI. Conclusions: The real new findings of our study are that the association between CAVI0 and diastolic blood pressure (DBP) is modified by age, whereas the association between CAVI and DBP is not modified by age. From a clinical point of view, these are very important findings, as DBP decreases with aging, affecting in elderly populations the reliability of CAVI0, which strictly depends on DBP in the formula to calculate it. To monitor the effect of CV therapies, progression of CV diseases and to evaluate clinical outcomes in elderly populations, we suggest using CAVI and not CAVI0.

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Section: Discussionmentioning

confidence: 99%

Cardio-Ankle Vascular Index and Aging: Differences between CAVI and CAVI0

Giani,

Micciolo,

Zoico

et al. 2023

JCM

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“…Therefore, the formula for estimating haPWV-relevant BP is incorrect, and there is no basis for the claim that the BP is almost P d . Also, they claim that the negative correlation with BP is because of high pulse pressure among the individuals with lower P d , who are supposed to have stiffer blood vessels [29]. However, a negative relationship is observed even in healthy people with pulse pressure less than 50 mmHg [34].…”

Section: Discussionmentioning

confidence: 99%

“…The superiority of CAVI compared with the other two parameters identified in the present study seems to be inconsistent to the findings of Spronck et al . [29] compared the same three arterial stiffness parameters in 154 individuals. They reported that the predictive ability of the composite endpoint [death ( n = 21) and heart failure hospitalization ( n = 18)] showed a decreasing trend of haPWV to CAVI to CAVI 0 , and the investigators attributed these results to the increasing amount of BP correction of the parameters.…”

Section: Discussionmentioning

confidence: 99%

Predictive ability of arterial stiffness parameters for renal function decline: a retrospective cohort study comparing cardio-ankle vascular index, pulse wave velocity and cardio-ankle vascular index0

Nagayama

Fujishiro

Miyoshi

et al. 2022

Journal of Hypertension

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Objective: The relative usefulness of arterial stiffness parameters on renal function remains controversial. This study aimed to compare the predictive ability of three arterial stiffness parameters at baseline; cardio-ankle vascular index (CAVI), heart-ankle pulse wave velocity (haPWV) and CAVI 0 , a variant of CAVI that theoretically excludes dependence on blood pressure, for renal function decline in Japanese general population.Methods: A total of 27 864 Japanese urban residents without renal impairment at baseline who participated in two to eight consecutive (mean 3.5 AE 1.7 times) annual health examinations were studied.Results: During the study period, 6.6% of participants developed renal function decline (estimated glomerular filtration rate <60 ml/min per 1.73 m 2 ), all of whom had relatively high values in all arterial stiffness parameters. In receiver-operating characteristic curve analysis, the discriminatory power for renal function decline showed a decreasing trend of CAVI to haPWV to CAVI 0 (C-statistic: 0.740 vs. 0.734 vs. 0.726). The cut-offs were CAVI 8.0, haPWV 7.23 and CAVI 0 11.6. In Cox-proportional hazards analysis for increase of each parameter above cut-off or by 1 standard deviation (SD) adjusted for two models of confounders, only CAVI always contributed significantly to renal function decline. Restricted cubic spline regression analysis suggested that CAVI most accurately reflected the risk of renal function decline. Conclusion:Increase in arterial stiffness parameters, especially CAVI, may represent a major modifiable risk factor for renal function decline in the general population. Further research is needed to examine whether CAVIlowering interventions contribute to the prevention of chronic kidney disease.

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“…The remarkable relationship between age and CAVI was previously demonstrated by Shirai et al [ 46 ], who described increased CAVI in elderly subjects as a possible expression of age-related arterial wall sclerosis. Although PVW-cf is still considered as the primary arterial stiffness evaluation technique for outcome prediction [ 47 ], CAVI could be also considered as a more reliable index in the elderly, due to its lower dependence from blood pressure [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

The Correlation of Arterial Stiffness Parameters with Aging and Comorbidity Burden

Fantin

Giani

Trentin

et al. 2022

JCM

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The aim of the study was to evaluate the relationships between carotid-femoral pulse wave velocity (PVW-cf), cardio-ankle vascular index (CAVI) and CAVI0 (which is a mathematical elaboration of CAVI, theoretically less dependent on blood pressure), age and comorbidity burden. Furthermore, 183 patients (119 female, mean age 67.5 ± 14.3 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included; demographic, clinical and blood analysis data were collected. Charlson Comorbidity Index (CCI), PVW-cf, CAVI and CAVI 0 were obtained. Significant correlations were found between CAVI, CAVI0, PVW-cf and both age (r = 0.698, r = 0.717, r = 0.410, respectively p < 0.001 for all) and CCI, (r = 0.654; r = 0.658; r = 0.448 respectively and p < 0.001 for all), still significant after adjustment for several variables. In a stepwise multiple regression model, considering several variables, CCI was the only predictor of PWV-cf, whereas age and CCI were significant predictors of both CAVI and CAVI 0. In conclusion, all arterial stiffness indexes are associated with CCI and aging; the latter correlation is more evident for CAVI and CAVI 0 than for PVW-cf. Arterial stiffness parameters can complement the characterization of patients affected by a remarkable comorbidity burden across aging; arterial stiffening might mirror the complexity of these individuals.

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Predictive Ability of Pressure-Corrected Arterial Stiffness Indices: Comparison of Pulse Wave Velocity, Cardio-Ankle Vascular Index (CAVI), and CAVI0

Cited by 14 publications

References 40 publications

Cardio-Ankle Vascular Index and Aging: Differences between CAVI and CAVI0

Cardio-Ankle Vascular Index and Aging: Differences between CAVI and CAVI0

Predictive ability of arterial stiffness parameters for renal function decline: a retrospective cohort study comparing cardio-ankle vascular index, pulse wave velocity and cardio-ankle vascular index0

The Correlation of Arterial Stiffness Parameters with Aging and Comorbidity Burden

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