Relationships Between the Cardio-Ankle Vascular Index and Pulsatility Index of the Common Carotid Artery in Patients With Cardiovascular Risk Factors

Abstract

Background Pulsatility index (PI) is a hemodynamic parameter determined using Doppler sonography; it reflects the degree of peripheral vascular resistance. Moreover, researchers have reported significant relationships between an increase in the PI of the common carotid artery (CCA) and ischemic stroke. This cross-sectional study aimed to clarify the relationships between cardio-ankle vascular index (CAVI) as a marker of arterial stiffness and the PI of the CCA in patients with cardiovascular risk factors for the primary prevention of ischemic stroke. Methods A total of 405 outpatients undergoing treatment for cardiovascular risk factors (152 men and 253 women; mean age ± standard deviation, 64 ± 9 years) with no history of cardiovascular events, including ischemic stroke, were enrolled. The CAVI and the PI of the CCA were measured using commercial devices, and their relationships to various clinical parameters were examined. Results A significant positive correlation was observed between the CAVI and the PI of the CCA (r = 0.44, P < 0.001). Further, multiple regression analysis revealed that the CAVI (β = 0.19, P < 0.001) was selected as independent factor for PI of the CCA as a subordinate factor. Meanwhile, high-sensitivity C-reactive protein, as an inflammation marker, and skin autofluorescence, as a marker of advanced glycation end products in the tissues, were selected as independent variables for either the CAVI or the PI of the CCA as a subordinate factor. The receiver-operating characteristic curve analysis indicated that the cut-off point of the CAVI for high PI of the CCA (> 1.60) as a risk value of stroke incidence by previous report was 9.1 (area under the curve = 0.750, P < 0.001). Conclusion The present results indicate that the CAVI reflects cerebrovascular resistance in patients with cardiovascular risk factors. Moreover, the risk value of the CAVI for ischemic stroke incidence was considered to be 9.1 in these patients.

Hemodynamic parameters and diabetes mellitus in community-dwelling middle-aged adults and elders: a community-based study

“…Inserting an intraarterial catheter is the most accurate method of assessing pulsatile hemodynamics, however, multiple studies indicated that non-invasive methods could be reasonable surrogates for invasive ones 31 – 33 . Hemodynamic parameters including blood velocities such as PSV, EDV, and MFV as well as PI and RI were used to study their clinical correlation with different cardiovascular conditions including but not limited to stroke 34 – 39 , hypertension 40 – 42 , arterial stenosis 43 – 46 .…”

Clinical Significance of the Cardio-Ankle Vascular Index in Postmenopausal Women With Hypercholesterolemia

“…Several clinical studies have reported that carotid atherosclerosis, which is evaluated through carotid artery ultrasonography, can indicate systemic atherosclerosis and be used as a predictor of CVD events [ 20 , 28 , 29 ]. However, several researchers have indicated significant associations between the CAVI and parameters of carotid artery ultrasonography [ 30 - 32 ]. The findings of the present study also indicated that the max-C-IMT, one of the parameters for carotid atherosclerosis, was significantly associated with the CAVI.…”

Sex- and Age-Related Physiological Profiles for Brachial, Vertebral, Carotid, and Femoral Arteries Blood Flow Velocity Parameters During Growth and Aging (4–76 Years): Comparison With Clinical Cut-Off Levels

“…As an example, low common carotid artery (CCA) PSV, and EDV are independently associated with cardiovascular disease (CVD) and events (e.g., stroke, heart disease) (Chuang et al, 2011(Chuang et al, , 2016; high internal carotid artery (ICA) PSV contributes to predict and grade ICA stenosis (Tokunaga et al, 2016); and low common femoral artery (CFA) PSV is predictive of ipsilateral iliac occlusion (Shaalan et al, 2003). On the other hand, CCA PI, and RI are associated with the prevalence of cerebral atherosclerosis and cardiovascular events (e.g., ischemic stroke) (Hitsumoto, 2019), ICA PI is associated with the global burden of small vessels disease (Lau et al, 2018), and CFA PI contributes to detecting peripheral vascular disease (Clifford et al, 1981). In turn, ICA/CCA velocity ratios contribute to detect and define arterial stenosis (Kochanowicz et al, 2009).…”