Cardio-Ankle Vascular Index: Test-Retest Reliability and Agreement in People With Stroke
Lily Y W Ho1,2, Claudia K Y Lai2, Shamay S M Ng1
1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR.
Insights
The cardio-ankle vascular index (CAVI) shows good reliability for clinical use. Higher CAVI values correlate with fatigue and poorer sleep quality in stroke survivors, indicating its potential in stroke patient assessment.
Area of Science:
- Vascular physiology
- Biomedical engineering
- Clinical assessment
Background:
- Arterial stiffness measurement is crucial for cardiovascular health assessment.
- The cardio-ankle vascular index (CAVI) offers a more advanced method than traditional techniques.
- Clinical adoption of CAVI has been limited despite scientific evidence.
Purpose of the Study:
- To evaluate the test-retest reliability and agreement of CAVI measurements.
- To investigate the correlation between CAVI, fatigue, and sleep quality.
- To compare CAVI in stroke patients, differentiating between paretic and non-paretic sides and fatigue status.
Main Methods:
- Sixty-seven participants were assessed using CAVI, Fatigue Assessment Scale, and Pittsburgh Sleep Quality Index.
- Test-retest reliability was analyzed using correlation coefficients and Bland-Altman plots.
- Standard error of measurement and minimal detectable change were calculated.
Main Results:
- CAVI demonstrated good test-retest reliability (0.77–0.86) and agreement.
- CAVI values correlated with fatigue and, on the paretic side, with sleep quality.
- Paretic limb CAVI was higher than non-paretic limb CAVI; fatigued stroke survivors had elevated CAVI.
Conclusions:
- CAVI exhibits robust test-retest reliability and measurement agreement, supporting its clinical utility.
- CAVI is a potential biomarker for assessing arterial stiffness, fatigue, and sleep disturbances in stroke patients.
- Findings suggest CAVI can differentiate between stroke-affected and unaffected sides and identify heightened vascular stiffness in fatigued individuals.
Abstract:
The cardio-ankle vascular index (CAVI) is superior to traditional methods of measuring arterial stiffness. However, its application in clinical practice has lagged behind the science. This study aimed to (1) examine its test-retest reliability and agreement between repeated measurements, (2) identify the correlation with fatigue and sleep quality, and (3) compare the CAVI values of the bilateral sides of people with stroke, and those of stroke survivors with and without fatigue. Participants (n = 67) were assessed using the CAVI, Fatigue Assessment Scale, and Pittsburgh Sleep Quality Index. The test-retest reliability ranged from 0.77 to 0.86. The Bland-Altman plots showed good agreement between test and retest. The standard error of measurement ranged from 0.59 to 0.66. The minimal detectable change ranged from 1.15 to 1.29. The CAVI values of the bilateral sides correlated with fatigue and those at the paretic side correlated with sleep quality. The CAVI values of the paretic side were higher than those of the non-paretic side in people with stroke. Stroke participants with fatigue had higher CAVI values than those without fatigue. CAVI has good test-retest reliability and agreement between repeated measurements for clinical use.
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