Successful prediction of clinical outcomes using arterial velocity pulse index, a new non-invasive vascular index, in Japan

Abstract

Objectives: Earlier detection of vascular stiffness and endothelial dysfunction will be useful in preventing atherosclerotic catastrophic conditions. Individuals with high risks for future cardiovascular (CV) events should be recognized by physicians to strengthen preventive therapeutic procedures, such as antihypertensive therapy, antidiabetic therapy, and antidyslipidemic therapy. As such, various non-invasive devices have been developed and are currently applied in clinical settings. Among them, we previously reported arterial velocity pulse index (AVI) and arterial pressure volume index (API) measured using a cuff-oscillometric-based medical electronic blood pressure monitor. These are significantly correlated with arterial stiffness and cardiac overload; therefore, these indexes might be useful in predicting future CV events. Materials and methods: We performed survival and CV event analyses in a total of 180 subjects with various clinical implications who visited Yokohama City University Hospital between May 2013 and March 2015 and followed them up until March 2016. The mean age was 66±13 years, and 101 subjects (56.1%) were men. A total of 116 subjects (64.4%) had hypertension, 87 subjects (48.3%) had dyslipidemia, and 39 subjects (21.7%) had diabetes mellitus. The mean AVI and API were 23.3±7.7 and 31.8±8.4, respectively. Results: The mean follow-up duration was 769±275 days. A total of 13 major adverse cardiac events (MACEs) occurred during the observational period, which consisted of 1 cardiac death, 8 CV events, and 4 hospitalizations owing to heart failure. After we performed Kaplan-Meier analysis, univariate Cox proportional hazard regression analysis, and multivariate Cox proportional hazard regression analysis, we found that AVI is significantly correlated with the risk of MACE. Therefore, we successfully revealed the clinical implications of the new non-invasive indexes for CV mortality and morbidity. Conclusion: The new non-invasive vascular index, AVI, was significantly correlated with the CV outcomes in our Japanese cohort.

A Noninvasive Arterial Stiffness Index to Estimate the Severity of Coronary Atherosclerosis in Patients Undergoing Coronary Angiography

“…Based on the measurement principle and these results, the AVI can be considered as a vascular index that reflects central arterial stiffness and cardiac afterload. Our previous study reported that the AVI has a predictive value for the risk of composite events of MACE and hospitalization due to HF in cardiology outpatients [19]. Another study reported that the AVI was a strong predictor of the composite of all-cause death and rehospitalization for HF in patients admitted for acute HF [20].…”

“…However, few studies have examined the relationship between these measures and the occurrence of CV events [19,20]. In the present retrospective cohort study, we aimed to investigate the relationship between the arterial stiffness indices (AVI and API) and the occurrence of CV events in patients with apparent or subclinical atherosclerosis in Japan.…”