Cardio-Ankle Vascular Index Reflects Impaired Exercise Capacity and Predicts Adverse Prognosis in Patients With Heart
Koichiro Watanabe1, Akiomi Yoshihisa1,2, Yu Sato1
1Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
Insights
A high cardio-ankle vascular index (CAVI) is linked to reduced exercise capacity and increased cardiac events in heart failure patients. This finding highlights CAVI as a potential prognostic marker for heart failure management.
Area of Science:
- Cardiology
- Vascular Physiology
- Heart Failure Research
Background:
- Heart failure (HF) management requires accurate assessment of exercise capacity and prognosis.
- Cardio-ankle vascular index (CAVI) is a measure of arterial stiffness.
- The relationship between CAVI, exercise capacity, and prognosis in HF patients needs further elucidation.
Purpose of the Study:
- To investigate the association between CAVI and exercise capacity in patients with decompensated heart failure.
- To evaluate the prognostic value of CAVI regarding cardiac events in HF patients.
Main Methods:
- Clinical data from 223 hospitalized decompensated HF patients were analyzed.
- Cardiopulmonary exercise testing (CPET) and CAVI measurements were performed.
- Multivariate logistic and Cox proportional hazard analyses were used to assess associations and predictors.
Main Results:
- A CAVI cutoff of 8.9 predicted impaired peak oxygen uptake (VO2 < 14 mL/kg/min).
- High CAVI (≥ 8.9) was an independent predictor of impaired exercise capacity (OR 2.343, P=0.045).
- High CAVI was associated with a higher rate of post-discharge cardiac events (log-rank P=0.004) and was an independent predictor (HR 1.845, P=0.035).
Conclusions:
- Elevated CAVI is significantly associated with reduced exercise capacity in heart failure patients.
- High CAVI independently predicts a higher incidence of cardiac events in HF patients.
- CAVI may serve as a valuable tool for risk stratification and prognosis assessment in heart failure.
Abstract:
Aims: We aimed to assess the associations of CAVI with exercise capacity in heart failure (HF) patients. In addition, we further examined their prognosis. Methods: We collected the clinical data of 223 patients who had been hospitalized for decompensated HF and had undergone both CAVI and cardiopulmonary exercise testing. Results: For the prediction of an impaired peak oxygen uptake (VO2) of < 14 mL/kg/min, receiver-operating characteristic curve demonstrated that the cutoff value of CAVI was 8.9. In the multivariate logistic regression analysis for predicting impaired peak VO2, high CAVI was found to be an independent factor (odds ratio 2.343, P = 0.045). We divided these patients based on CAVI: the low-CAVI group (CAVI < 8.9, n = 145) and the high-CAVI group (CAVI ≥ 8.9, n = 78). Patient characteristics and post-discharge cardiac events were compared between the two groups. The high-CAVI group was older (69.0 vs. 58.0 years old, P < 0.001) and had lower body mass index (23.0 vs. 24.1 kg/m2, P = 0.013). During the post-discharge follow-up period of median 1,623 days, 58 cardiac events occurred. The Kaplan-Meier analysis demonstrated that the cardiac event rate was higher in the high-CAVI group than in the low-CAVI group (log-rank P = 0.004). The multivariate Cox proportional hazard analysis revealed that high CAVI was an independent predictor of cardiac events (hazard ratio 1.845, P = 0.035). Conclusion: High CAVI is independently associated with impaired exercise capacity and a high cardiac event rate in HF patients.
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