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The Association Between the Cardio-ankle Vascular Index and Other Parameters of Vascular Structure and Function in
Leticia Gomez-Sanchez1, Luis Garcia-Ortiz, Maria C Patino-Alonso
1Primary Care Research Unit, the Alamedilla Health Center.
Insights
The cardio-ankle vascular index (CAVI) score is positively associated with vascular structure and function, independent of cardiovascular risk factors. This index shows similar predictive ability for carotid atherosclerosis as other measures in adults.
Area of Science:
- Cardiovascular research
- Vascular biology
- Diagnostic imaging
Background:
- Arterial stiffness is a key indicator of cardiovascular health.
- Existing measures of arterial stiffness include carotid intima media thickness (IMT) and pulse wave velocity (PWV).
- The cardio-ankle vascular index (CAVI) is a novel measure of arterial stiffness.
Purpose of the Study:
- To determine the association between CAVI and established vascular parameters: IMT, PWV, and central augmentation index (CAIx).
- To assess if this association is independent of cardiovascular risk factors and medication.
- To compare the predictive ability of CAVI for carotid atherosclerosis with other measures.
Main Methods:
- CAVI was measured in 500 subjects using a VaSera device.
- Carotid ultrasound assessed IMT.
- Brachial-ankle PWV (ba-PWV) and carotid-femoral PWV (cf-PWV) were measured.
- CAIx was measured using a Mobil-O-Graph device.
- Cardiovascular risk was assessed using Framingham-D'Agostino and SCORE scales.
Main Results:
- CAVI showed a significant positive association with IMT, CAIx, and PWV (p < 0.01) after adjusting for cardiovascular risk, BMI, and medications.
- CAVI demonstrated comparable sensitivity and specificity to cf-PWV and ba-PWV in predicting mean IMT > 0.90 mm.
- Optimal CAVI cut-off values were identified for predicting carotid atherosclerosis.
Conclusions:
- CAVI is independently associated with vascular structure and function parameters.
- CAVI's ability to predict carotid atherosclerosis is comparable to cf-PWV and ba-PWV in Caucasian adults.
- CAVI represents a valuable tool for assessing arterial stiffness and cardiovascular risk.
Aim:
We assessed whether there is an association between the cardio-ankle vascular index (CAVI) score and the carotid intima media thickness (IMT), the pulse wave velocity (PWV) and the central augmentation index (CAIx) that is independent of the subject's cardiovascular risk and pharmacological treatment.
Methods:
The CAVI score was measured in 500 subjects using a VaSera device and the brachial ankle PWV (ba-PWV) was calculated. A carotid ultrasound was used to measure the IMT. A Mobil-O-Graph device was used to measure the carotid femoral PWV (cf-PWV) and the CAIx. The Framingham-D'Agostino and SCORE scales were used to measure the subject's cardiovascular risk.
Results:
The mean value of the CAVI score was 8.59 ± 1.1. IMT, CAIx and PWV maintained a positive association with the CAVI score (p ＜ 0.01) in a multiple linear regression analysis, after adjusting for the subject's cardiovascular risk, body mass index and pharmacological treatment. The cut-off level that gave the maxima sensitivity and specificity to detect a mean IMT of ＞ 0.90 mm was 8.95 (AUC=0.67) for the CAVI score, 8.85 (AUC=0.66) for cf-PWV and 15.10 (AUC=0.66) for ba-PWV. The cut-off to detect a maxima IMT of ＞ 0.90 mm was 8.60 (AUC=0.62) for the CAVI score, 8.85 (AUC=0.64) for cf-PWV and 15.75 (AUC=0.70) for ba-PWV.
Conclusion:
There was a positive association of the CAVI score with vascular structure and function parameters that was independent of cardiovascular risk and any medications being used by the subject. The ability of the CAVI score to predict carotid atherosclerosis is similar to that of cf-PWV and ba-PWV in Caucasian adults.