Reduced arterial stiffness in patients with acromegaly: non-invasive assessment by the cardio-ankle vascular index (CAVI)

Matsuda, Yayoi; Kawate, Hisaya; Matsuzaki, Chitose; Sakamoto, Ryuichi; Abe, Ichiro; Shibue, Kazuhisa; Kohno, Masanori; Adachi, Masahiro; Ohnaka, Keizo; Nomura, Masatoshi; Takayanagi, Ryoichi

doi:10.1507/endocrj.ej12-0189

Cited by 14 publications

(13 citation statements)

References 29 publications

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“…They suggested that premature cardiovascular disease in patients with acromegaly was related to pressure-related arterial stiffness and left ventricular stiffness rather than atherosclerosis. On the contrary, Matsuda et al (13) have demonstrated reduced arterial stiffness in patients with acromegaly using the cardio-ankle vascular index. In this study the cardio-ankle vascular index showed a significant negative correlation with the serum IGF-1 level.…”

Section: Discussionmentioning

confidence: 94%

“…Arterial stiffness is currently regarded as an independent predictor of cardiovascular morbidity and mortality (11). Increased arterial stiffness increases left ventricular load by increasing systolic blood pressure, contributing to left ventricular hypertrophy and leads to a decrease in perfusion pressure in coronary arteries by decreasing in diastolic blood pressure and causing myocardial ischemia (12,13). The 2007 Arterial Hypertension Treatment Notice of the European Society of Hypertension reported that high blood pressure is an important determinant for cardiovascular events in the presence of cardiovascular risk factors in the age group above 55 years.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it is an important determinant for vascular diseases including cardiac failure, myocardial infarction, renal disease, stroke and dementia (11,12). In a study by Matsuda et al (13) there were decreased arterial stiffness in patients with acromegaly while elevated aortic stiffness was reported in the study by Nemes et al (14).…”

Section: Introductionmentioning

confidence: 97%

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Mean platelet volume and arterial stiffness in patients with acromegaly

Ünübol¹,

Güney²,

Türe³

et al. 2014

Anadolu Kardiyol Derg

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Objective: There are still contradictory data in the literature whether patients with acromegaly are under risk in terms of atherosclerotic heart disease. Increased arterial stiffness develops before atherosclerosis and is evaluated to be a risk factor for atherosclerosis. Mean platelet volume (MPV) is currently gaining interest as a new independent cardiovascular risk factor. There are contrasting views about arterial stiffness in patients with acromegaly. There is no report in literature studying MPV in acromegaly patients. The aim of this study was to evaluate MPV and arterial stiffness in patients with acromegaly. Methods: This study was designed as an observational cross-sectional, case-controlled study. Twenty-eight patients with acromegaly and 22 healthy volunteers were recruited for the study. The arteriography device Mobil-O-Graph ® (IEM GmbH. Stolberg, Germany) which can perform oscillometric measurements was used to measure arterial stiffness. The Mann-Whitney U test, Student's t-test, Spearman's nonparametric correlation analysis and the chi-square test were used to statistical analyze. Results: Aortic pulse wave velocity (PWV) value was found to be 6.41±2.12 m/s in the patient group with active acromegaly and 5.24±1.04 m/s in the healthy control group. The difference was statistically significant (p=0.03). The mean MPV value was found to be 9.68±1.11 in the patient group with active acromegaly and 8.53±1.18 in the healthy control group. There was a statistically significant difference between the two groups (p=0.004). In patients with acromegaly, a positive correlation was found between MPV and insulin-like growth hormone-I (IGF-1) level (p=0.021, r=0.434). Conclusion:We determined an increase in aortic PWV and MPV in patients with acromegaly. In conclusion, evaluation of MPV and arterial stiffness in future studies could be beneficial in determining the risks for cardiovascular disease in patients with acromegaly.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Mean platelet volume and arterial stiffness in patients with acromegaly

Ünübol¹,

Güney²,

Türe³

et al. 2014

Anadolu Kardiyol Derg

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“…This software is able to automatically recognize the edges of the internal and external membranes of blood vessels and measure the distance at a sub-pixel level, using a three-dimensional polynomial measurement formula [19,20]. Images were obtained in the 20-mm region proximal to the origin of the bulb at the far wall of the right common carotid artery.…”

Section: Measurement Of Imtmentioning

confidence: 99%

Eplerenone improves carotid intima-media thickness (IMT) in patients with primary aldosteronism

et al. 2016

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PRIMARY ALDOSTERONISM (PA) is characterized by excessive secretion of the mineralocorticoid hormone aldosterone and is frequently caused by an aldosterone-secreting adrenocortical adenoma or adrenal hyperplasia [1,2]. PA is the most frequent form of secondary hypertension and has been estimated to affect 5-15% of hypertensive patients [3][4][5]. Moreover, the prevalence of PA has been found to correlate with the severity of hypertension [6,7], and patients with PA are at higher risk for cardiovascular events than those with essential hypertension [8][9][10] Abstract. Primary aldosteronism (PA) is associated with a higher rate of cardiovascular events than essential hypertension. Although adrenalectomy has been reported to reduce carotid intima-media thickness (IMT) in patients with PA, the effects of the selective aldosterone blocker, eplerenone, on vascular damage in these patients remains unclear. To evaluate the effects of eplerenone on vascular status in PA patients, we sequentially measured carotid IMT (using computer software to calculate an average IMT for accurate and reproducible evaluation) in 22 patients including 8 patients treated by unilateral adrenalectomy and 14 patients treated with eplerenone for 12 months. Patients who underwent adrenalectomy showed significant reductions in aldosterone concentration (from 345 ± 176 pg/mL to 67 ± 34 pg/mL; P<0.01) and IMT (from 0.67 ± 0.07 mm to 0.63 ± 0.09 mm; P<0.05) 6 months after surgery. Patients treated with eplerenone showed significant reductions in IMT from baseline (0.75 ± 0.10 mm) to 6 (0.71 ± 0.11 mm; P<0.05) and 12 (0.65 ± 0.09 mm; P<0.01) months, although plasma aldosterone level increased significantly, from 141 ± 105 pg/mL to 207 ± 98 pg/mL (P<0.05). Eplerenone treatment of patients with PA reduces blood pressure, increases serum potassium level, and improves vascular status. Carotid IMT may be a useful marker for evaluating the effectiveness of eplerenone in patients with PA.

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“…After a baseline value has been established, subsequent follow-ups of the CAVI scores can then serve as reliable indicators of disease progression that are valuable in evaluating the outcomes after physical48 or pharmacological85–87 treatment. The cardiovascular impact of intrinsic35,76 or extrinsic58,67,83 factors can also be evaluated in well-controlled studies.…”

Section: Cavi: Clinical and Research Applicationsmentioning

confidence: 99%

Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness

Sun

2013

IBPC

116

103

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Arterial stiffness has been identified as an independent predictor of prognostic outcomes for patients with cardiovascular disease. Although measurement of pulse wave velocity has been a widely accepted noninvasive approach to the assessment of arterial stiffness, its accuracy is hampered by changes in blood pressure. Taking the exponential relation between intravascular pressure and arterial diameter into consideration, a stiffness parameter can be obtained by plotting the natural logarithm of systolic–diastolic pressure ratio against the arterial wall extensibility. Cardio-ankle vascular index (CAVI), which is calculated based on the stiffness parameter thus obtained, is theoretically independent of changes in blood pressure. With this distinct advantage, CAVI has been widely applied clinically to assess arterial stiffness in subjects with known cardiovascular diseases including those with diagnosed atherosclerosis, coronary heart disease, and stroke as well as those at risk, including those with hypertension, diabetes, the elderly, and the obese. Because of its enhanced sensitivity, not only has the index been used to discern subtle changes in the disease process, it has also been utilized in studying normal individuals to assess their potential risks of developing cardiovascular diseases. The primary aims of assessing arterial stiffness using CAVI are not only to aid in early detection of arteriosclerosis to allow timely treatment and change in lifestyle, but also to quantitatively evaluate the progression of disease and the effectiveness of treatment. Despite its merit of being unaffected by blood pressure, discretion in data interpretation is suggested because an elevated CAVI represents not just vascular stiffness caused by pathological changes in the arterial wall, but can also be attributed to an increased vascular tone brought about by smooth muscle contraction. Moreover, certain patient populations, such as those with an ankle-brachial index < 0.9, may give falsely low CAVI and are suggested to be excluded from study.

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Reduced arterial stiffness in patients with acromegaly: non-invasive assessment by the cardio-ankle vascular index (CAVI)

Cited by 14 publications

References 29 publications

Mean platelet volume and arterial stiffness in patients with acromegaly

Mean platelet volume and arterial stiffness in patients with acromegaly

Eplerenone improves carotid intima-media thickness (IMT) in patients with primary aldosteronism

Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness

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