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Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
[Informativity of Indicators of the Arterial Wall Stiffness for Screening Studies]
A E Nosov1, A S Baydina1, E M Vlasova1
1Medical and Preventive Health Risk Management Technologies.
Insights
The Augmentation Index (AI) is more sensitive and accurate than the Cardio-Ankle Vascular Index (CAVI) for screening cardiovascular risk. However, CAVI demonstrates higher specificity in identifying patients at risk from metabolic syndrome and arterial stiffness.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Biomedical Engineering
Background:
- Metabolic syndrome (MS) and elevated arterial stiffness are significant risk factors for severe cardiovascular complications.
- Screening tools are crucial for identifying at-risk individuals, particularly those with combined metabolic and vascular risk factors.
Purpose of the Study:
- To comparatively assess the informativity of the Cardio-Ankle Vascular Index (CAVI) and Augmentation Index (AI) for screening patients at risk of cardiovascular complications.
- To evaluate the diagnostic performance of CAVI and AI in patients with metabolic syndrome and arterial stiffness.
Main Methods:
- A study involving 206 mining industry employees with cardiac risk factors (hypertension, obesity, smoking) and a comparative group of 75 employees without these factors.
- Measurement of arterial wall stiffness using CAVI and AI, followed by calculation of sensitivity, specificity, and accuracy for screening.
Main Results:
- AI demonstrated higher sensitivity (2x) and accuracy (1.4-1.6x) compared to CAVI in identifying patients with cardiovascular risk markers.
- CAVI exhibited significantly higher specificity (86.2%) than AI (34.4%) in patients with both clinical-anamnestic and laboratory risk factors.
- Metabolic risk factors (glucose, cholesterol, triglycerides, Atherogenic Index) showed differences only for AI when comparing patient groups with high vs. normal AI and CAVI.
Conclusions:
- Arterial stiffness parameters, AI and CAVI, possess distinct informative values for screening cardiovascular risk.
- AI offers superior sensitivity and accuracy for screening, while CAVI provides better specificity, making them complementary tools in risk assessment for metabolic syndrome and arterial stiffness.
Objective:
comparative assessment of informativity of parameters of arterial wall stiffness - the cardio-ankle vascular index (CAVI), the augmentation index (AI) - for solution of problems of screening patients being under threat of realization of complex impact of metabolic syndrome (MS) and elevated vessel wall stiffness, both creators and markers of high risk of severe cardiovascular complications.
Materials And Methods:
We examined mining industry employees (n=206) with cardiac risk factors (arterial hypertension, abdominal obesity, and smoking). Comparative group comprised 75 employees of the same enterprise without above-mentioned risk factors. Studies of arterial wall stiffness included determination of CAVI and AI. The sensitivity, specifcity and accuracy of the screening method were calculated.
Results:
CAVI and AI parameters had different sensitivity, specifcity and accuracy for identifying patients at risk of cardiovascular complications. AI was 2 times more sensitive than CAVI during examination of patients with only clinical and anamnestic cardiovascular risk markers and patients with clinical-anamnestic and laboratory risk markers. Specifcity of AI was lower than specifcity of CAVI and atained only 34.4% in patients with clinical-anamnestic and laboratory risk factors. At the same time, specifcity of CAVI in these patients reached 86.2%. Accuracy of AI for screening study was 1.4 times higher than that of CAVI in patients with only clinical-anamnestic risk markers, and 1.6 times higher in patients with both clinical-anamnestic and laboratory risk markers. Moreover, after comparing patient groups with individually high and normal CAVI and AI, we found the differences in metabolic laboratory risk factors (glucose, total cholesterol, triglycerides and the Atherogenic Index) only for AI.
Conclusion:
Parameters of arterial stiffness have different informative value for screening of patients with clinical-anamnestic or laboratory risk factors. AI compared with CAVI is 2 times more sensitive and 1.6 times more accurate but has lower specifcity for risk factor screening among patients being under threat of realization of complex impact of MS and elevated vessel wall stiffness.
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