[Cardio-ankle vascular index (CAVI) and cardiovascular disease]

Increased arterial stiffness is closely associated with the progression of cardiovascular disease. A novel blood-pressure independent arterial stiffness parameter, the cardio-ankle vascular index (CAVI), has been developed and is used worldwide. Arterial stiffness derived using CAVI in healthy subjects increases linearly with aging, and is higher in men than in women. This is a new finding, not observed with conventional arterial stiffness indicators. In patients with risk factors such as hypertension, diabetes, hypercholesterolemia, left ventricular hypertrophy, chronic kidney disease and hyperuricemia, CAVI values are higher than in controls. Antihypertensive, antidiabetic, and antilipemic medications are effective in lowering elevated CAVI. Among the antiplatelet agents, highly purified eicosapentaenoic acid (EPA) in fish oil has the effect of lowering CAVI. It is also useful in the evaluation of the effects of lifestyle modification. It has been shown that CAVI values are elevated even with mild arteriosclerotic disease, and differences in the degree of arteriosclerosis can be estimated between patients with severe arteriosclerotic disease, for example those with ischemic cardiac disease and dialysis patients. In coronary artery disease, CAVI reflect the severity of the diseased coronary artery and latent plaque in coronary arteries using intravascular ultrasound imaging(IVUS). It is also reported that patients with higher CAVI values have a poor prognosis compared with those with lower CAVI values. Its advantage of reproducibility, with little disparity among institutions, has opened up the way for multi-center joint studies.