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Tano S, Kotani T, Matsuo S, Ushida T, Imai K, Kajiyama H. Identifying the high-benefit population for weight management-based cardiovascular disease prevention in Japan. Prev Med Rep 2024; 43:102782. [PMID: 39026567 PMCID: PMC11257143 DOI: 10.1016/j.pmedr.2024.102782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/24/2024] [Accepted: 06/01/2024] [Indexed: 07/20/2024] Open
Abstract
Background Cardiovascular-disease (CVD) is the leading cause of death, and the association between obesity and CVD is particularly significant among women. Given the evidence highlighting the significance of weight-gain velosity, we aimed to elucidate its influence on cardio-ankle vascular index (CAVI), a reliable surrogate marker of CVD, and identify the high-benefit population where this influence is most pronounced. Methods This multicenter retrospective study used electronic data from annual health checkups for workers in Japan. Individuals who voluntarily measured CAVI in 2019 were included, and weight-gain velosity was defined as the mean BMI gain from 2015 to 2019. Our primary outcome was the relationship between weight-gain velosity and CAVI. Results Among 459 individuals, 53 had CAVI ≥ 9. Random forest analysis revealed that age was the most important factor, followed by lipid metabolism, weight-gain velosity, and glucose metabolism, with sex being the least important. Non-linear regression analysis of the effect of age on CAVI ≥ 9 showed the effect was pronounced after age 60, and the trend was greater in women. Among individuals aged 60 or younger, the aOR of weight-gain velosity for CAVI ≥ 9 was significantly positive (aOR 11.95, 95 %CI 1.13-126.27), while it was not significant for those older than 60. The relationship between weight-gain velosity and CAVI provides a new perspective on CVD risk factors. The effects of age, especially after 60, and weight-gain velosity in early- to middle-adulthood on arterial stiffness are emphasized. Conclusions These findings underscore the importance of weight management under age 60, especially in women.
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Affiliation(s)
- Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Division of Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Division of Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Seiko Matsuo
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takafumi Ushida
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kenji Imai
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Saiki A, Takahashi Y, Nakamura S, Yamaoka S, Abe K, Tanaka S, Watanabe Y, Yamaguchi T, Nagayama D, Ohira M, Oshiro T, Tatsuno I, Shirai K. Relationship between Lipoprotein Lipase Derived from Subcutaneous Adipose Tissue and Cardio-Ankle Vascular Index in Japanese Patients with Severe Obesity. Obes Facts 2024; 17:255-263. [PMID: 38342095 PMCID: PMC11149971 DOI: 10.1159/000537687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/24/2024] [Indexed: 02/13/2024] Open
Abstract
INTRODUCTION Cardio-ankle vascular index (CAVI) is an arterial stiffness index that correlates inversely with body mass index (BMI) and subcutaneous fat area. Lipoprotein lipase (LPL) that catalyzes the hydrolysis of serum triglycerides is produced mainly in adipocytes. Serum LPL mass reflects LPL expression in adipose tissue, and its changes correlate inversely with changes in CAVI. We hypothesized that LPL derived from subcutaneous adipose tissue (SAT) suppresses the progression of arteriosclerosis and examined the relationship of LPL gene expression in different adipose tissues and serum LPL mass with CAVI in Japanese patients with severe obesity undergoing laparoscopic sleeve gastrectomy (LSG). METHODS This study was a single-center retrospective database analysis. Fifty Japanese patients who underwent LSG and had 1-year postoperative follow-up data were enrolled (mean age 47.5 years, baseline BMI 46.6 kg/m2, baseline HbA1c 6.7%). SAT and visceral adipose tissue (VAT) samples were obtained during LSG surgery. LPL gene expression was analyzed by real-time PCR. Serum LPL mass was measured by ELISA using a specific monoclonal antibody against LPL. RESULTS At baseline, LPL mRNA expression in SAT correlated positively with serum LPL mass, but LPL mRNA expression in VAT did not. LPL mRNA expression in SAT was correlated, and serum LPL mass tended to correlate inversely with the number of metabolic syndrome symptoms, but LPL mRNA expression in VAT did not. LPL mRNA expression in SAT and CAVI tended to correlate inversely in the group with visceral-to-subcutaneous fat ratio of 0.4 or higher, which is considered metabolically severe. Serum LPL mass increased 1 year after LSG. Change in serum LPL mass at 1 year after LSG tended to be an independent factor inversely associated with change in CAVI. CONCLUSIONS Serum LPL mass reflected LPL mRNA expression in SAT in Japanese patients with severe obesity, and LPL mRNA expression in SAT was associated with CAVI in patients with visceral obesity. The change in serum LPL mass after LSG tended to independently contribute inversely to the change in CAVI. This study suggests that LPL derived from SAT may suppress the progression of arteriosclerosis.
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Affiliation(s)
- Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Yuka Takahashi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Shoko Nakamura
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Shuhei Yamaoka
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Kazuki Abe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Sho Tanaka
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Daiji Nagayama
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- Nagayama Clinic, Tochigi, Japan
| | - Masahiro Ohira
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Takashi Oshiro
- Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Kohji Shirai
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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Ishii Y, Noguchi H, Sato J, Takahashi I, Ishii H, Ishii R, Ishii K, Ishii K, Toyabe SI. Arterial Stiffness, Assessed Using the Cardio-Ankle Vascular Index, before and 2 Years after Total Knee Arthroplasty in Patients with Knee Osteoarthritis. J Clin Med 2023; 12:7734. [PMID: 38137803 PMCID: PMC10743671 DOI: 10.3390/jcm12247734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/10/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Purpose: Cardiovascular disease (CVD) is a major risk factor for mortality in patients with osteoarthritis, and such comorbidities increase the risk of postoperative complications following total knee arthroplasty (TKA). Arteriosclerosis plays a major role in hemodynamic dysfunction and CVD; however, the postoperative changes in arteriosclerosis following TKA have not been evaluated. Therefore, we assessed the postoperative changes in arteriosclerosis using the cardio-ankle vascular index (CAVI) in patients undergoing TKA, and its relationships with preoperative patient characteristics. Methods: Arteriosclerosis was prospectively evaluated in 119 consecutive patients (140 knees) (15 males (17), 104 females (123); median age 73 years) with knee osteoarthritis who underwent TKA. CAVI was measured before and 2 years after TKA, and the relationships between CAVI and preoperative age, sex, BMI, physical activity status, comorbidities, clinical score, triglyceride concentration, cholesterol concentration, and smoking history were analyzed. Results: CAVI remained stable or improved in 54 joints (39%) and worsened in 86 joints (61%) 2 years post-operation. The median difference between pre- and postoperative CAVI was 0.2 (-0.3, 0.8), and the only preoperative factor associated with this change was preoperative CAVI (r = -0.469, p < 0.001). No other preoperative factor had a significant effect on postoperative arteriosclerosis. Conclusions: The results suggest that patients who undergo TKA subsequently show less severe arteriosclerosis, and the protective effect of TKA on arterial stiffness is greater in those with a higher preoperative CAVI. TKA may be an effective means of reducing the deterioration of arteriosclerosis associated with knee osteoarthritis, at least in the relatively short term.
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Affiliation(s)
- Yoshinori Ishii
- Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda 361-0037, Saitama, Japan; (H.N.); (J.S.); (I.T.)
| | - Hideo Noguchi
- Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda 361-0037, Saitama, Japan; (H.N.); (J.S.); (I.T.)
| | - Junko Sato
- Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda 361-0037, Saitama, Japan; (H.N.); (J.S.); (I.T.)
| | - Ikuko Takahashi
- Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda 361-0037, Saitama, Japan; (H.N.); (J.S.); (I.T.)
| | - Hana Ishii
- School of Plastic Surgery, Kanazawa Medical University, 1-1 Daigaku Uchinada, Ishikawa 920-0253, Japan;
| | - Ryo Ishii
- Shinshu University Hospital, 3-1-1 Asahi Matsumoto, Nagano 390-8621, Japan;
| | - Kei Ishii
- Iwate Prefectural Chuo Hospital, 1-4-1 Ueda, Morioka 020-0066, Japan;
| | - Kai Ishii
- Kouseiren Takaoka Hospital, 5-10 Eirakutyo Takaoka, Toyama 933-8555, Japan;
| | - Shin-ichi Toyabe
- Niigata University Crisis Management Office, Niigata University Hospital, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata 951-8520, Japan;
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Nagayama D, Krakauer JC, Krakauer NY, Sugiura T, Watanabe Y, Shimizu K, Saiki A, Suzuki K, Fujishiro K, Shirai K. Cumulative Cigarette Consumption is Associated with Cardio-Ankle Vascular Index (CAVI) Mediated by Abdominal Obesity Assessed by A Body Shape Index (ABSI): A Cross-Sectional Study. J Atheroscler Thromb 2023; 30:1870-1881. [PMID: 37197950 DOI: 10.5551/jat.64221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
AIM To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness. METHODS Cross-sectional data from 19499 never smokers and 5406 current smokers receiving health screening was analyzed. Abdominal obesity was assessed by ABSI, and arterial stiffness by CAVI. High CAVI was defined as CAVI ≥ 9.0. RESULTS Current smoker showed higher ABSI than never smokers after propensity score matching. Cumulative cigarette consumption expressed in pack-years correlated with ABSI (Rs: 0.312 in men, 0.252 in women), and was also extracted as an independent factor associated with ABSI by multiple regression analysis. A linear relationship between pack-year and CAVI was observed (Rs: 0.544 in men, 0.423 in women). Pack-year had almost equal discriminatory power in predicting high CAVI in both sexes (C-statistic: 0.774 in men, 0.747 in women), and the best cut-offs of pack-year for high CAVI were 24.5 in men and 14.7 in women. Bivariate logistic regression models revealed that the association between pack-year higher than cut-off and high CAVI was independent of traditional risks. A mediating effect of ABSI (mediation rate: 9.9% in men and 11.2% in women), but not waist circumference (WC), on the association of pack-year with CAVI was observed, after adjusting for traditional risks. CONCLUSION Cumulative cigarette smoking in pack-years was independently associated with ABSI. ABSI partially mediates the association between pack-year and CAVI, suggesting that abdominal obesity partially mediates smoking-related vascular dysfunction.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | | | - Nir Y Krakauer
- Department of Civil Engineering, City College of New York
| | | | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Kazuhiro Shimizu
- Division of Cardiovascular Medicine, Toho University, Sakura Medical Center
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Kenji Suzuki
- Research and Development Division, Japan Health Promotion Foundation
| | - Kentaro Fujishiro
- Research and Development Division, Japan Health Promotion Foundation
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital
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Palić B, Brizić I, Sher EK, Cvetković I, Džidić-Krivić A, Abdelghani HTM, Sher F. Effects of Zofenopril on Arterial Stiffness in Hypertension Patients. Mol Biotechnol 2023:10.1007/s12033-023-00861-5. [PMID: 37702881 DOI: 10.1007/s12033-023-00861-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/29/2023] [Indexed: 09/14/2023]
Abstract
Angiotensin-converting enzyme inhibitors (ACEIs) reduce arterial stiffness beyond their antihypertensive effect. Studies showed that sulfhydryl ACEIs have the antioxidative potential to improve endothelial function, which might have a clinical effect on arterial distensibility. However, there are no studies that directly compare the effects of sulfhydryl (zofenopril) and non-sulfhydryl ACEIs (enalapril) on arterial stiffness. Therefore, this prospective study aims to compare the effects of enalapril and zofenopril on arterial stiffness and oxidative stress in both short- and long-term treatment of arterial hypertension (AH). Baseline and post-treatment peripheral and central arterial pressure indices, augmentation index (Aix), aortic pulse wave velocity (ao-PWV), serum levels of oxidized low-density cholesterol lipoprotein, LDL and uric acid (UA) were measured. The results showed that acute treatment with zofenopril, in contrast to enalapril, significantly decreased peripheral and central Aix (p < 0.001). Chronic treatment with zofenopril showed a superior effect over enalapril on the reduction of the peripheral systolic arterial pressure with reduction of ao-PWV (p = 0.004), as well as a reduction in peripheral Aix (p = 0.021) and central Aix (p = 0.021). Therefore, this study indicates that zofenopril has beneficial effects on the reduction of arterial stiffness compared to enalapril. It has potent clinical efficacy in AH treatment and further studies should compare its safety and long-term efficacy to other AH drugs that would aid clinicians in treating AH and other various cardiovascular diseases that have arterial stiffness as a common denominator.
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Affiliation(s)
- Benjamin Palić
- Department of Internal Medicine, University Clinical Hospital Mostar, 88000, Mostar, Bosnia and Herzegovina
| | - Ivica Brizić
- Department of Internal Medicine, University Clinical Hospital Mostar, 88000, Mostar, Bosnia and Herzegovina
| | - Emina Karahmet Sher
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK.
| | - Ivona Cvetković
- Department of Laboratory Diagnostics, University Clinical Hospital Mostar, 88000, Mostar, Bosnia and Herzegovina
| | - Amina Džidić-Krivić
- Department of Neurology, Cantonal Hospital Zenica, 72000, Zenica, Bosnia and Herzegovina
- International Society of Engineering Science and Technology, Nottingham, UK
| | - Heba Taha Mohmmed Abdelghani
- Department of Physiology of Physical Activity, College of Sport Sciences and Physical Activity, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Farooq Sher
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK.
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A Body Shape Index (ABSI) as a Variant of Conicity Index Not Affected by the Obesity Paradox: A Cross-Sectional Study Using Arterial Stiffness Parameter. J Pers Med 2022; 12:jpm12122014. [PMID: 36556235 PMCID: PMC9783005 DOI: 10.3390/jpm12122014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/20/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
A body shape index (ABSI) is an abdominal obesity index developed based on epidemiological statistics and designed to correlate minimally with body mass index (BMI). We examined the approximation between ABSI and other abdominal obesity indices based on biophysical concepts. The cross-sectional data from 62,514 Japanese urban residents were analyzed. Body adiposity indices comprising BMI, waist circumference (WC), ABSI, conicity index (CI), waist-to-height ratio (WHtR), and WC/BMI ratio were examined. ABSI and CI more strongly correlated with age and arterial stiffness assessed by cardio-ankle vascular index (CAVI) compared to the other indices. The discriminative power for high CAVI (≥9.0) was the strongest for ABSI followed by CI and other indices, in that order. The range and distribution of WC corresponding to the cutoff of ABSI (0.0801), or CI (1.23) seemed reasonable. The correlation between ABSI and CI was the strongest compared to any other combination of indices. CI correlated moderately with BMI, whereas ABSI correlated minimally with BMI. ABSI correlates strongly and approximates closely with CI. Hence, ABSI may be considered to reflect the degree of body shape change from cylindricity to conicity and is currently the only abdominal obesity index not affected by the obesity paradox.
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Kim S, Choi SY, Lee H, Ju Kim J, Eun Park H. Sex and Age Differences in the Impact of Metabolic Syndrome and Its Components including A Body Shape Index on Arterial Stiffness in the General Population. J Atheroscler Thromb 2022; 29:1774-1790. [PMID: 35354700 PMCID: PMC9881533 DOI: 10.5551/jat.63371] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AIM We investigated the effects of metabolic syndrome (MetS) and its components, including a body shape index (ABSI), on increased arterial stiffness measured using the cardio-ankle vascular index (CAVI) according to sex and age strata. METHODS A total of 7127 asymptomatic Korean participants aged 21-90 years (men, 69.4%) were included. Age-sex-specific increased CAVI was defined as having the highest quartile of CAVI in each age group. RESULTS The CAVI increased with age and was higher in men. MetS was associated with an increased risk of high CAVI by 1.30 times in men and 1.45 times in women. The risk of high CAVI with an increasing MetS risk score was greater in women. MetS was significantly associated with increased CAVI in men only aged 51-70 years and in women aged ≥ 51 years, and the size of association increased with age (odds ratio (OR) of 1.41 in 51-70 years vs. OR of 2.96 in ≥ 71 years of women). Among MetS components, triglyceride (men, all ages), hypertension (men, 51-70 years; women, ≤ 70 years), glucose intolerance (men, 51-70 years; women, ≥ 51 years), and HDL-cholesterol (women, ≥ 71 years) were associated with increased CAVI.Unlike increased waist circumference (WC), increased ABSI revealed an association with high CAVI. MetS diagnosed with ABSI instead of WC was more significantly associated with increased CAVI in all age-sex groups. CONCLUSION The association of MetS and its components with increased CAVI differed with age and sex, which might provide a new insight for the management of MetS risk factors to promote vascular health.
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Affiliation(s)
- Sunmie Kim
- Department of Obstetrics and Gynecology,
Seoul National University College of Medicine, Seoul National University Hospital
Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Su-Yeon Choi
- Department of Internal Medicine,
Seoul National University College of Medicine, Seoul National University Hospital Healthcare
System Gangnam Center, Seoul, Republic of Korea
| | - Heesun Lee
- Department of Internal Medicine,
Seoul National University College of Medicine, Seoul National University Hospital Healthcare
System Gangnam Center, Seoul, Republic of Korea
| | - Jin Ju Kim
- Department of Obstetrics and Gynecology,
Seoul National University College of Medicine, Seoul National University Hospital
Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Hyo Eun Park
- Department of Internal Medicine,
Seoul National University College of Medicine, Seoul National University Hospital Healthcare
System Gangnam Center, Seoul, Republic of Korea
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Cardio-Vascular Interaction Evaluated by Speckle-Tracking Echocardiography and Cardio-Ankle Vascular Index in Hypertensive Patients. Int J Mol Sci 2022; 23:ijms232214469. [PMID: 36430943 PMCID: PMC9692763 DOI: 10.3390/ijms232214469] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/13/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
Hypertension increases arterial stiffness, leading to dysfunction and structural changes in the left atrium (LA) and left ventricle (LV). However, the effects of hypertension on the right atrium (RA) and the right ventricle are still not fully understood. The purpose of this study was to clarify whether there is an interaction not only in the left ventricular system but also in the right ventricular system in hypertensive patients with preserved LV ejection fraction. The current retrospective observational study included patients (n = 858) with some risk of metabolic abnormalities (hypertension, diabetes, and dyslipidemia) who had visited our hospital and undergone echocardiography between 2015 and 2018. Among them, we retrospectively studied 165 consecutive hypertensive patients with preserved LV ejection fraction who had echocardiography performed on the same day as a cardio-ankle vascular index (CAVI) in our hospital. The phasic function of both atria was evaluated by two-dimensional speckle-tracking echocardiography. CAVI was measured using Vasela 1500 (Fukuda Denshi®). In the univariate analysis, CAVI was significantly correlated with LA and RA conduit function (LA conduit function, r = -0.448, p = 0.0001; RA conduit function, r = -0.231, p = 0.003). A multivariate regression analysis revealed that LA and RA conduit function was independently associated with CAVI (LA, t = -5.418, p = 0.0001; RA, t = -2.113, p = 0.036). CAVI showed a possibility that the association between heart and vessels are contained from not only LA phasic function but also RA phasic function in hypertensive patients.
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Budoff MJ, Alpert B, Chirinos JA, Fernhall B, Hamburg N, Kario K, Kullo I, Matsushita K, Miyoshi T, Tanaka H, Townsend R, Valensi P. Clinical Applications Measuring Arterial Stiffness: An Expert Consensus for the Application of Cardio-Ankle Vascular Index. Am J Hypertens 2022; 35:441-453. [PMID: 34791038 PMCID: PMC9088840 DOI: 10.1093/ajh/hpab178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/03/2021] [Accepted: 11/11/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The purpose of this document is to provide clinicians with guidance, using expert consensus, to help summarize evidence and offer practical recommendations. METHODS Expert Consensus Documents are intended to provide guidance for clinicians in areas in which there are no clinical practice guidelines, especially for new and evolving tests such as arterial stiffness measurements, until any formal guidelines are released. RESULTS This expert consensus document is intended as a source of information for decision-making and to guide clinician-patient discussions in various clinical scenarios. CONCLUSIONS The goal is to help clinicians and patients make a more informed decision together.
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Affiliation(s)
- Matthew J Budoff
- Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, California, USA
| | - Bruce Alpert
- Department of Medicine, University of Tennessee Medical Group, Memphis, Tennessee, USA
| | - Julio A Chirinos
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bo Fernhall
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Naomi Hamburg
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kazuomi Kario
- Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Iftikhar Kullo
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Kunihiro Matsushita
- Department of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Toru Miyoshi
- Department of Medicine, Okayama University, Okayama, Japan
| | - Hirofumi Tanaka
- Department of Medicine, The University of Texas at Austin, Austin, Texas, USA
| | - Ray Townsend
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paul Valensi
- Unit of Endocrinology-Diabetology-Nutrition, Department of Medicine, Jean Verdier Hospital, AP-HP, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
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Rerkasem A, Tangmunkongvorakul A, Aurpibul L, Sripan P, Parklak W, Nantakool S, Srithanaviboonchai K, Rerkasem K. Association of cardio-ankle vascular index and future major adverse cardiovascular events in older adults living with HIV. AIDS Care 2022; 35:591-599. [PMID: 35499141 DOI: 10.1080/09540121.2022.2029820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACTIncreased arterial stiffness is an indicator of cardiovascular disease (CVD) and death in the general population. The cardio-ankle vascular index (CAVI) is a novel method for measuring arterial stiffness. This study investigated the utility of CAVI as a prognostic indicator of CVD and death in older adults living with HIV(OALHIV). Patients aged ≥50 taking antiretroviral treatment with no history of cardiovascular events enrolled from multiple centers in Chiang Mai, Thailand. Participants (N = 347) who underwent CAVI were followed up for five years. The primary endpoint was major adverse cardiovascular events (MACE): a composite of total deaths and hospitalizations due to myocardial infarction, coronary revascularization, stroke, and heart failure. Cox regression analysis determined between normal (<8) and high (≥8) CAVI against the incidence of MACE. Forty-five participants (13.0%) were diagnosed with MACE. The risk of MACE was more significant in high CAVI than normal CAVI (adjusted HR = 2.11, 95% confidence interval 1.06-4.20, p = 0.033). In OALHIV, CAVI was an independent prognosis of MACE, in addition to conventional CVD risk factors. CAVI-assisted to help identify high-risk patients showed the benefit of further evaluation and more intensive therapy to prevent CVD and death.
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Affiliation(s)
- Amaraporn Rerkasem
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Arunrat Tangmunkongvorakul
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Linda Aurpibul
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Wason Parklak
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sothida Nantakool
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical Surgical Research Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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11
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Choi JM, Park HE, Han YM, Lee J, Lee H, Chung SJ, Lim SH, Yim JY, Chung GE. Non-alcoholic/Metabolic-Associated Fatty Liver Disease and Helicobacter pylori Additively Increase the Risk of Arterial Stiffness. Front Med (Lausanne) 2022; 9:844954. [PMID: 35280895 PMCID: PMC8914072 DOI: 10.3389/fmed.2022.844954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundNon-alcoholic fatty liver disease (NAFLD) and Helicobacter pylori (Hp) infection have a close association with an increased risk of cardiovascular disease. Metabolic dysfunction-associated fatty liver disease (MAFLD) is characterized by metabolic dysfunction in NAFLD. We investigated the synergistic effects of NAFLD/MAFLD and Hp infection on the risk of arterial stiffness in an asymptomatic population.MethodsWe included individuals who underwent abdominal ultrasonography, anti-Hp IgG antibody evaluations and cardio-ankle vascular index (CAVI) during health screening tests between January 2013 and December 2017. Arterial stiffness was defined using CAVI. A logistic regression model was used to analyze the independent and synergistic effects of NAFLD/MAFLD and Hp infection on the risk of arterial stiffness.ResultsAmong 3,195 subjects (mean age 54.7 years, 68.5% male), the prevalence of increased arterial stiffness was 36.4%. In the multivariate analysis, subjects with NAFLD but without Hp infection and those with both NAFLD and Hp infection had a significantly higher risk of increased arterial stiffness [odds ratio (OR) 1.61, 95% confidence interval (CI) 1.15–2.26, and OR 2.23, 95% CI 1.63–3.06, respectively], than subjects without Hp infection and NAFLD. Regarding MAFLD, Hp infection additively increased the risk of arterial stiffness in subjects with MAFLD (OR 2.13, 95% CI 1.64–2.78).ConclusionsAn interactive effect of Hp infection on the risk of arterial stiffness in individuals with NAFLD/MAFLD was observed. Hp infection additively increases the risk of arterial stiffness in subjects with NAFLD or MAFLD.
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Affiliation(s)
- Ji Min Choi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Hyo Eun Park
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Yoo Min Han
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Jooyoung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Heesun Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Su Jin Chung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Seon Hee Lim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Jeong Yoon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Goh Eun Chung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
- *Correspondence: Goh Eun Chung
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12
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Nagayama D, Watanabe Y, Yamaguchi T, Suzuki K, Saiki A, Fujishiro K, Shirai K. Issue of Waist Circumference for the Diagnosis of Metabolic Syndrome Regarding Arterial Stiffness: Possible Utility of a Body Shape Index in Middle-Aged Nonobese Japanese Urban Residents Receiving Health Screening. Obes Facts 2022; 15:160-169. [PMID: 35008086 PMCID: PMC9021625 DOI: 10.1159/000520418] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. This cross-sectional study aimed to clarify whether replacing WC with "A Body Shape Index (ABSI)," an abdominal obesity index, in MetS diagnosis detects individuals with arterial stiffening assessed by cardio-ankle vascular index (CAVI). METHODS A retrospective cross-sectional study was conducted in 46,872 Japanese urban residents (median age 40 years) who underwent health screening. Exclusion criteria were current treatments and a past history of cardiovascular disease (CVD). The Japanese, International Diabetes Federation, and NCEP-ATPIII criteria were used to diagnose MetS. High CAVI was defined as CAVI ≥9.0. RESULTS CAVI correlated positively with ABSI (β = 0.127), but negatively with WC (β = -0.186), independent of age, sex, systolic blood pressure, fasting plasma glucose, and high-density lipoprotein--cholesterol. Receiver operating characteristic (ROC) analysis showed that ABSI had a stronger contribution to high CAVI (area under the ROC curve [AUC] = 0.730) than WC (AUC = 0.595) and body mass index (AUC = 0.520). ABSI ≥0.080 was defined as abdominal obesity based on the results of ROC analysis for high CAVI and estimated glomerular filtration rate <60 mL/min/1.73 m2. Logistic regression analysis revealed that replacing high WC with ABSI ≥0.080 in MetS diagnosis enhanced the detection of subjects with high CAVI. DISCUSSION/CONCLUSION Use of ABSI can detect subjects with arterial stiffening, which may lead to efficient stratification of CVD risk. Further studies are needed to confirm whether MetS diagnosis using ABSI predicts CVD morbidity and mortality.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
- *Daiji Nagayama,
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | | | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | | | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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13
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Nagayama D, Fujishiro K, Tsuda S, Watanabe Y, Yamaguchi T, Suzuki K, Saiki A, Shirai K. Enhanced prediction of renal function decline by replacing waist circumference with "A Body Shape Index (ABSI)" in diagnosing metabolic syndrome: a retrospective cohort study in Japan. Int J Obes (Lond) 2021; 46:564-573. [PMID: 34824353 PMCID: PMC8872991 DOI: 10.1038/s41366-021-01026-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 11/09/2022]
Abstract
Background Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. Objective To examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index calculated by dividing WC by an allometric regression of weight and height, in MetS diagnosis is useful for predicting renal function decline. Subjects/Methods In total, 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years were enrolled. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI). The predictability of the new-onset renal function decline (eGFR < 60 mL/min/1.73 m2) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, IDF and NCEP-ATPIII. Results In Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan–Meier analysis of the rate of new-onset renal function decline over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSI-MetS than in those without (log-rank test p < 0.001), but almost no difference between subjects with and without WC-MetS (p = 0.014–0.617). In gender-specific Cox-proportional hazards analyses including age, proteinuria, and treatments of metabolic disorders as confounders, ABSI-MetS (Japanese criteria for both sexes, IDF criteria for men) contributed independently to the new-onset renal function decline. Of these, the contribution of IDF ABSI-MetS disappeared after adjustment by high CAVI in the subsequent analysis. Conclusion In this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of renal function decline and arterial stiffening.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, 2-12-22, Tenjin-cho, Oyama-city, Tochigi, 3230032, Japan. .,Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan.
| | - Kentaro Fujishiro
- Japan Health Promotion Foundation, 1-24-4, Ebisu, Shibuya-ku, Tokyo, 1500013, Japan
| | - Shinichi Tsuda
- Fukuda Denshi Co., Ltd., 3-39-4, Hongo, Bunkyo-ku, Tokyo, 1130033, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Kenji Suzuki
- Japan Health Promotion Foundation, 1-24-4, Ebisu, Shibuya-ku, Tokyo, 1500013, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Kohji Shirai
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan.,Department of Internal Medicine, Mihama Hospital, 1-1-5, Uchise, Mihama-ku, Chiba, 2610013, Japan
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14
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Shinohara M, Fujino T, Wada R, Yano K, Akitsu K, Koike H, Kinoshita T, Ikeda T. Predictive value of the cardio-ankle vascular index for recurrence of atrial fibrillation after catheter ablation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2021; 44:1861-1873. [PMID: 34605033 DOI: 10.1111/pace.14373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/31/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The predictive value of the cardio-ankle vascular index (CAVI) for estimating the efficacy outcome of catheter ablation (CA) in atrial fibrillation (AF) patients is unclear. We aimed to examine the predictive performance of the CAVI for recurrences of atrial arrhythmias after CA. METHODS We enrolled a total of 193 patients with AF (paroxysmal 126 and non-paroxysmal 67) who underwent initial CA procedures at our institute, and CAVI measurements were conducted between January 2016 and March 2017. We evaluated recurrences of atrial arrhythmias after the first CA procedure as a clinical outcome. The CAVI value was assessed and the enrolled patients were divided according to the optimal CAVI value cut-off point (9.5) in the atrial arrhythmia recurrence group. RESULTS During a mean follow-up of 31.3 (17.5-43.0) months, 74 (32.5%; PaAF 41 and 49.3%; non-PaAF 33) patients had recurrences of atrial arrhythmias. The recurrence ratio of atrial arrhythmias was significantly higher in patients with a high CAVI (≥9.5) than those with a low CAVI (<9.5) (log rank test; p = 0.018). A univariate analysis showed the association between higher CAVI values and recurrences of atrial arrhythmias (p = 0.072). Multivariate analyses using a Cox proportional hazard model after adjusting for other clinical factors revealed that the CAVI value was determined to be a significant predictive factor of a recurrence of atrial arrhythmias after CA (Hazard ratio: 1.44, 95% confidence interval: 1.17-1.78, p < 0.01). CONCLUSIONS The CAVI was significantly associated with a recurrence of atrial arrhythmias after CA in AF patients.
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Affiliation(s)
- Masaya Shinohara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Tadashi Fujino
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Ryo Wada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Kensuke Yano
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Katsuya Akitsu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Hideki Koike
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Toshio Kinoshita
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
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15
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Miyoshi T, Ito H. Arterial stiffness in health and disease: The role of cardio-ankle vascular index. J Cardiol 2021; 78:493-501. [PMID: 34393004 DOI: 10.1016/j.jjcc.2021.07.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 12/11/2022]
Abstract
Arterial stiffness increases with age, as well as in various pathological states, including obesity, diabetes mellitus, smoking, and dyslipidemia, and it has important consequences for cardiovascular health. Arterial stiffness plays a central role in hemodynamic dysfunction characterized by excess pulsatility; specifically, it leads to heart failure, cerebrovascular disease, and renal failure. Among measures of arterial stiffness, carotid-femoral pulse wave velocity is considered as the reference standard; however, it has not been incorporated into routine clinical practice. Cardio-ankle vascular index (CAVI), which is a marker of arterial stiffness measured from the origin of the aorta to the ankle, was developed in 2004. CAVI is based on stiffness parameter β, which is theoretically independent of blood pressure at the time of measurement. CAVI applies stiffness parameter β to arterial segments between the heart and ankle. The measurement of CAVI is simple and well-standardized, and its reproducibility and accuracy are acceptable. Several studies have demonstrated that CAVI is high in patients with various atherosclerotic risk factors, and treatment of cardiovascular risk factors and lifestyle modifications improve CAVI. Several prospective studies have investigated the association between CAVI and future cardiovascular events in the general population and in patients with cardiovascular risk factors. A cut-off value of 9.0 is proposed for predicting patients at a high risk of cardiovascular events. From this review, it is clear that CAVI may be useful in the prevention of cardiovascular disease.
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Affiliation(s)
- Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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16
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Nagayama D, Saiki A, Watanabe Y, Yamaguchi T, Ohira M, Sato N, Kanayama M, Moroi M, Miyashita Y, Shirai K, Tatsuno I. Prevention of Cardiovascular Events with Pitavastatin is Associated with Increased Serum Lipoprotein Lipase Mass Level: Subgroup Analysis of the TOHO-LIP. J Atheroscler Thromb 2021; 29:451-463. [PMID: 33642441 PMCID: PMC9090481 DOI: 10.5551/jat.62141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim:
To clarify the mechanism by which pitavastatin reduced cardiovascular (CV) events more effectively than atorvastatin in the TOHO Lipid Intervention Trial Using Pitavastatin (TOHO-LIP), the changes in (Δ) non-heparinized serum level of lipoprotein lipase mass (LPL mass) during administration of the respective statins were investigated.
Methods:
From TOHO-LIP data, 223 hypercholesterolemic patients with any CV risks followed at Toho University Sakura Medical Center were analyzed. The patients were randomized to pitavastatin (2 mg/day) group (
n
=107) or atorvastatin (10 mg/day) group (
n
=116), and followed for 240 weeks. In this subgroup study, the primary and secondary end points were the same as those in TOHO-LIP, and 3-point major adverse cardiovascular events (3P-MACE) was added. The relationship between ΔLPL mass during the first year and the incidences of each end point was analyzed.
Results:
The lipid-lowering effect was not different between the two statins. Cumulative 240-week incidence of each end point was significantly lower in pitavastatin group (primary: 1.9% vs. 10.3%, secondary: 4.7% vs. 18.1%, 3P-MACE: 0.9% vs. 6.9%). Mean LPL mass (64.9 to 69.0 ng/mL) and eGFR (70.1 to 73.6 ml/min/1.73m
2
) increased in pitavastatin group, but not in atorvastatin group during the first year. Cox proportional-hazards model revealed that ΔLPL mass (1 ng/mL or 1SD) contributed to almost all end points.
Conclusions:
Pitavastatin administration reduced CV events more efficaciously than atorvastatin despite similar LDL cholesterol-lowering effect of the two statins. Increased LPL mass during the first year by pitavastatin treatment may be associated with this efficacy.
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Affiliation(s)
- Daiji Nagayama
- Nagayama Clinic.,Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Naoko Sato
- Pharmaceutical Unit, Toho University Sakura Medical Center
| | | | - Masao Moroi
- Division of Cardiovascular Medicine (Ohashi), Department of Internal Medicine, Faculty of Medicine, Toho University
| | | | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
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17
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Shimizu K, Takahashi M, Sato S, Saiki A, Nagayama D, Harada M, Miyazaki C, Takahara A, Shirai K. Rapid Rise of Cardio-Ankle Vascular Index May Be a Trigger of Cerebro-Cardiovascular Events: Proposal of Smooth Muscle Cell Contraction Theory for Plaque Rupture. Vasc Health Risk Manag 2021; 17:37-47. [PMID: 33603388 PMCID: PMC7886257 DOI: 10.2147/vhrm.s290841] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/22/2021] [Indexed: 11/23/2022] Open
Abstract
Cardiovascular diseases have been recognized as the main cause of death all over the world. Recently, the established cardio-ankle vascular index (CAVI) has become known as an index of arterial stiffness of the arterial tree from the origin of the aorta to the ankle. CAVI reflects the progress of arteriosclerosis, and a rapid rise in CAVI indicates arterial smooth muscle cell contraction. Considering the vasculature of the atheroma where vasa vasorum penetrates the smooth muscle cell layer and supplies blood to the intimal atheromatous lesion, a rapid rise of CAVI means "choked" atheroma. Thus, we proposed a "smooth muscle cell contraction" hypothesis of plaque rupture.
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Affiliation(s)
- Kazuhiro Shimizu
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Chiba, Japan
| | - Mao Takahashi
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Chiba, Japan
| | - Shuji Sato
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Chiba, Japan
| | - Atsuhito Saiki
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Chiba, Japan
| | - Daiji Nagayama
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Chiba, Japan
| | - Masashi Harada
- Department of Neurosurgery, Toho University Omori Medical Center, Omori, Tokyo, Japan
| | - Chikao Miyazaki
- Department of Neurosurgery, Toho University Omori Medical Center, Omori, Tokyo, Japan
| | - Akira Takahara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Funabashi, Chiba, Japan
| | - Kohji Shirai
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Chiba, Japan
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18
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Onozaki A, Nagayama D, Azuma N, Sugai K, Shitara E, Sakai T, Masai M, Shirai K, Tatsuno I. Relation of Maximum Lifetime Body Mass Index with Age at Hemodialysis Initiation and Vascular Complications in Japan. Obes Facts 2021; 14:550-558. [PMID: 34515199 PMCID: PMC8546452 DOI: 10.1159/000518049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/16/2021] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the association of the maximum lifetime body mass index (max BMI) with hemodialysis initiation and comorbidities in Japanese hemodialysis patients. METHODS In a retrospective cross-sectional study on 724 hemodialysis patients, max BMI, age at hemodialysis initiation, and comorbidities including sleep apnea syndrome, cerebro-cardiovascular diseases, and proliferative diabetic retinopathy (PDR) were analyzed. Early hemodialysis initiation was defined as age <50 years. RESULT Diabetes patients showed a higher max BMI and prevalence of atherosclerotic diseases than nondiabetes patients, despite almost the same age at hemodialysis initiation. Patients with early hemodialysis initiation showed higher male ratio, prevalence of PDR, and max BMI than those with later initiation, despite almost equal prevalence of diabetes. Receiver-operating characteristic curve analysis determined a max BMI of 28.4 kg/m2 as a reliable cutoff value for predicting early hemodialysis initiation, and this parameter was identified as an independent predictor of early hemodialysis initiation using bivariate logistic regression analysis. Vitrectomy for PDR also tended to contribute independently to early hemodialysis initiation. CONCLUSION A high max BMI contributed to early hemodialysis initiation independent of diabetes. Furthermore, PDR was associated with a high max BMI and early hemodialysis initiation. These results suggest that weight reduction in young chronic kidney disease patients with obesity may prevent hemodialysis and blindness.
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Affiliation(s)
- Akira Onozaki
- Internal Medicine, Tokatsu Clinic Hospital, Chiba, Japan
| | - Daiji Nagayama
- Internal Medicine, Nagayama Clinic, Tochigi, Japan
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- *Daiji Nagayama,
| | - Nakanobu Azuma
- Internal Medicine, Tokatsu Clinic Hospital, Chiba, Japan
| | - Keita Sugai
- Nutrition Management Division, Mihama Hospital, Chiba, Japan
| | - Etsuko Shitara
- Nutrition Management Division, Mihama Hospital, Chiba, Japan
| | | | | | - Kohji Shirai
- Internal Medicine, Mihama Hospital, Chiba, Japan
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
- Chiba Prefectural University of Health Sciences, Chiba, Japan
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19
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Wang F, Chen HZ. Histone Deacetylase SIRT1, Smooth Muscle Cell Function, and Vascular Diseases. Front Pharmacol 2020; 11:537519. [PMID: 33117155 PMCID: PMC7573826 DOI: 10.3389/fphar.2020.537519] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/18/2020] [Indexed: 12/11/2022] Open
Abstract
Vascular smooth muscle cells (VSMCs), located in the media of artery, play key roles in maintaining the normal vascular physiological functions. Abnormality in VSMCs is implicated in vascular diseases (VDs), including atherosclerosis, abdominal aortic aneurysm (AAA), aortic dissection, and hypertension by regulating the process of inflammation, phenotypic switching, and extracellular matrix degradation. Sirtuins (SIRTs), a family of proteins containing seven members (from SIRT1 to SIRT7) in mammals, function as NAD+-dependent histone deacetylases and ADP-ribosyltransferases. In recent decades, great attention has been paid to the cardiovascular protective effects of SIRTs, especially SIRT1, suggesting a new therapeutic target for the treatment of VDs. In this review, we introduce the basic functions of SIRT1 against VSMC senescence, and summarize the contribution of SIRT1 derived from VSMCs in VDs. Finally, the potential new strategies based on SIRT1 activation have also been discussed with an emphasis on SIRT1 activators and calorie restriction to improve the prognosis of VDs.
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Affiliation(s)
- Fang Wang
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Hou-Zao Chen
- State Key Laboratory of Medical Molecular Biology, Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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20
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Nagayama D, Watanabe Y, Yamaguchi T, Saiki A, Shirai K, Tatsuno I. High hemoglobin glycation index is associated with increased systemic arterial stiffness independent of hyperglycemia in real-world Japanese population: A cross-sectional study. Diab Vasc Dis Res 2020; 17:1479164120958625. [PMID: 32985267 PMCID: PMC7919210 DOI: 10.1177/1479164120958625] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIMS To investigate the association of metabolic parameters including hemoglobin glycation index (HGI, observed HbA1c - predicted HbA1c) with systemic arterial stiffness assessed by cardio-ankle vascular index (CAVI). SUBJECTS We analyzed the cross-sectional data from 22,696 subjects (mean age 48.0 years, mean FPG 88 mg/dL, mean HbA1c 5.5%) with or without past history of metabolic disorders including diabetes. RESULTS Men had higher body mass index (BMI), CAVI, blood pressure (BP), FPG, HbA1c, total cholesterol and triglyceride; and lower age, HGI and HDL-cholesterol. After stratifying subjects into HGI quartiles, the highest quartile (Q4) group showed higher age, female ratio, and frequencies of obesity, hypertension, diabetes, and dyslipidemia. Furthermore, bivariate logistic regression model revealed that the Q4 of HGI was a significant predictor of high CAVI (⩾9.0) independent of the presence of diabetes. CONCLUSION High HGI is associated with systemic arterial stiffening independent of hyperglycemia. This index is therefore expected to be not only a predictor of hypoglycemia, but also a therapeutic guide for atherosclerosis.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine,
Nagayama Clinic, Oyama-City, Tochigi, Japan
- Daiji Nagayama, Department of Internal
Medicine, Nagayama Clinic, 2-12-22, Tenjin-Cho, Oyama-City, Tochigi 323-0032,
Japan.
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and
Metabolism, Toho University, Sakura Medical Center, Sakura-City, Chiba, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and
Metabolism, Toho University, Sakura Medical Center, Sakura-City, Chiba, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and
Metabolism, Toho University, Sakura Medical Center, Sakura-City, Chiba, Japan
| | - Kohji Shirai
- Department of Internal Medicine, Mihama
Hospital, Chiba-City, Chiba, Japan
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrinology and
Metabolism, Toho University, Sakura Medical Center, Sakura-City, Chiba, Japan
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Saiki A, Ohira M, Yamaguchi T, Nagayama D, Shimizu N, Shirai K, Tatsuno I. New Horizons of Arterial Stiffness Developed Using Cardio-Ankle Vascular Index (CAVI). J Atheroscler Thromb 2020; 27:732-748. [PMID: 32595186 PMCID: PMC7458785 DOI: 10.5551/jat.rv17043] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Arterial stiffness is recognized mainly as an indicator of arteriosclerosis and a predictor of cardiovascular events. Cardio-ankle vascular index (CAVI), which reflects arterial stiffness from the origin of the aorta to the ankle, was developed in 2004. An important feature of this index is the independency from blood pressure at the time of measurement. A large volume of clinical evidence obtained using CAVI has been reported. CAVI is high in patients with various atherosclerotic diseases including coronary artery disease and chronic kidney disease. Most coronary risk factors increase CAVI and their improvement reduces CAVI. Many prospective studies have investigated the association between CAVI and future cardiovascular disease (CVD), and proposed CAVI of 9 as the optimal cut-off value for predicting CVD. Research also shows that CAVI reflects afterload and left ventricular diastolic dysfunction in patients with heart failure. Furthermore, relatively acute changes in CAVI are observed under various pathophysiological conditions including mental stress, septic shock and congestive heart failure, and in pharmacological studies. CAVI seems to reflect not only structural stiffness but also functional stiffness involved in acute vascular functions. In 2016, Spronck and colleagues proposed a variant index CAVI0, and claimed that CAVI0 was truly independent of blood pressure while CAVI was not. This argument was settled, and the independence of CAVI from blood pressure was reaffirmed. In this review, we summarize the recently accumulated evidence of CAVI, focusing on the proposed cut-off values for CVD events, and suggest the development of new horizons of vascular function index using CAVI.
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Affiliation(s)
- Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | | | - Naomi Shimizu
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
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Arafat Y, Kucukosmanoglu M, Mustafa G. The relationship between the prevalence and complexity of coronary artery disease and aortic stiffness in myocardial infarction patients without ST-segment elevation. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2020. [DOI: 10.4103/ijca.ijca_46_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Kario K, Kanegae H, Oikawa T, Suzuki K. Hypertension Is Predicted by Both Large and Small Artery Disease. Hypertension 2019; 73:75-83. [PMID: 30571549 DOI: 10.1161/hypertensionaha.118.11800] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Both small and large artery disease might precede the development of hypertension. However, no prospective trial has yet determined the role of small and large artery disease on the rate of new-onset hypertension in a normotensive general population. This study investigated associations between both arterial stiffness and small artery retinopathy and the development of hypertension in adults from Japan. Normotensive individuals who underwent a baseline health checkup from 2005 to 2015 and at least 1 annual follow-up were eligible. The cardio-ankle vascular index (CAVI) was measured, and retinal fundus photography was performed at baseline. Follow-up visits included measurement of clinic blood pressure. The primary end point was new-onset hypertension (blood pressure ≥140/90 mm Hg or initiation of antihypertensive medication with self-reported hypertension). The analysis included 34 649 subjects (mean age, 44.2 years; 46.4% male). Mean follow-up duration was 3.18±2.50 years. The cumulative incidence of new-onset hypertension during the 10-year follow-up period was 40% of patients overall, with rates increasing in parallel with baseline CAVI (quartile [Q]1, 23%; Q2, 33%; Q3, 42%; Q4, 58%; P<0.001), and as the severity of retinopathy increased ( P<0.001). CAVI showed good discriminative ability for detecting new-onset hypertension. In multivariate analysis, both CAVI and small artery retinopathy were independent predictors of hypertension development. There was no interaction between CAVI and small artery retinopathy with respect to incident hypertension. In conclusion, we showed that both large and small artery disease predict future hypertension independently of each other and confounding risk factors in a general normotensive population.
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Affiliation(s)
- Kazuomi Kario
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., H.K.)
| | - Hiroshi Kanegae
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., H.K.).,Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K., T.O.)
| | - Takamitsu Oikawa
- Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K., T.O.)
| | - Kenji Suzuki
- Japan Health Promotion Foundation, Tokyo, Japan (K.S.)
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24
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Shin KA. Relationship between Arterial Stiffness as Measured by the Cardio-Ankle Vascular Index with Body Mass Index in Healthy Elderly Subjects. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2019. [DOI: 10.15324/kjcls.2019.51.3.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Kyung A Shin
- Department of Clinical Laboratory Science, Shinsung University, Dangjin, Korea
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25
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Sugiura T, Dohi Y, Takagi Y, Yoshikane N, Ito M, Suzuki K, Nagami T, Iwase M, Seo Y, Ohte N. Relationships of Obesity-Related Indices and Metabolic Syndrome with Subclinical Atherosclerosis in Middle-Aged Untreated Japanese Workers. J Atheroscler Thromb 2019; 27:342-352. [PMID: 31462618 PMCID: PMC7192820 DOI: 10.5551/jat.50633] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: Obesity is a social problem due to the prevalence of the Western lifestyle. In particular, visceral fat accumulation, which is a main component of metabolic syndrome, is closely associated with the progression of atherosclerosis. This study aimed to investigate the relationships of obesity-related indices and metabolic syndrome with subclinical atherosclerosis in middle-aged untreated workers. Methods: Employees undergoing their periodic health check-up but without previous cardiovascular events or cardiovascular medications were enrolled in this study (n = 7,750). Body mass index (BMI), percent body fat, waist circumference, and visceral fat area were evaluated as obesity-related indices. Assessment of visceral fat area was performed by computed tomography (CT). Subclinical atherosclerosis was assessed by measuring arterial stiffness using cardio-ankle vascular index (CAVI) and by ultrasound examination of carotid intima-media thickness (IMT). Results: Obesity-related indices were significantly correlated with each other and were positively associated with carotid IMT but negatively associated with CAVI in multivariate regression analysis. In a logistic regression analysis including CAVI and carotid IMT simultaneously, CAVI was negatively associated, but carotid IMT was positively associated, with obesity defined by each obesity-related index. In contrast, both CAVI and carotid IMT were positively associated with the presence of metabolic syndrome based on visceral fat accumulation. Conclusions: Obesity-related indices were negatively associated with CAVI and positively associated with carotid IMT in middle-aged untreated workers, while both CAVI and carotid IMT were worsened in the presence of metabolic syndrome.
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Affiliation(s)
- Tomonori Sugiura
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences.,Health Support Center WELPO, Toyota Motor Corporation
| | - Yasuaki Dohi
- Department of Internal Medicine, Faculty of Rehabilitation Science, Nagoya Gakuin University.,Health Support Center WELPO, Toyota Motor Corporation
| | - Yasuyuki Takagi
- Health Support Center WELPO, Toyota Motor Corporation.,Toyota Memorial Hospital
| | | | - Mitsuhisa Ito
- Health Support Center WELPO, Toyota Motor Corporation
| | - Kenji Suzuki
- Health Support Center WELPO, Toyota Motor Corporation
| | | | | | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | - Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
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Yamaguchi T, Shirai K, Nagayama D, Nakamura S, Oka R, Tanaka S, Watanabe Y, Imamura H, Sato Y, Kawana H, Ohira M, Saiki A, Shimizu N, Tatsuno I. Bezafibrate Ameliorates Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Hypertriglyceridemic Patients with Type 2 Diabetes Mellitus. J Atheroscler Thromb 2018; 26:659-669. [PMID: 30584220 PMCID: PMC6629745 DOI: 10.5551/jat.45799] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIM Cardio-ankle vascular index (CAVI) reflects arterial stiffness and has been established as a useful surrogate marker of atherosclerosis. Contrary to the abundant data indicating slower progression of atherosclerosis with statins, studies on fibrates remain scarce. The aim of this study was thus to clarify the effect of bezafibrate on CAVI as well as on oxidative stress. METHODS A randomized, open-label, controlled study was performed. 66 hypertriglyceridemic patients with type 2 diabetes were assigned to two groups: bezafibrate (400 mg/day) group and eicosapentaenoic acid (EPA 1.8 g/day) group. Patients were administered the respective treatment for 12 weeks. CAVI, glycolipid metabolic parameters, and diacron-reactive oxygen metabolites (d-ROMs) were evaluated before and after the study period. RESULTS Serum triglycerides (TG), remnant-like particle cholesterol (RLP-C), fasting plasma glucose, HbA1c and d-ROMs decreased, while HDL-cholesterol increased significantly in the bezafibrate group but did not change in the EPA group. The decreases in TG, RLP-C, HbA1c and d-ROMs were significantly greater in the bezafibrate group than in the EPA group. CAVI decreased significantly only in the bezafibrate group and the decrease was significantly greater in bezafibrate group than in EPA group. Simple regression analysis showed no significant relationship between the change in CAVI and changes in other variables. Multivariate logistic regression analysis identified high baseline CAVI, low HDL-cholesterol level, and bezafibrate administration as significant independent predictors of CAVI decrease. CONCLUSION Bezafibrate treatment ameliorates arterial stiffness accompanied by improvement of glycolipid metabolism and oxidative stress. These effects potentially have important beneficial health consequences in hypertriglyceridemic patients with type 2 diabetes.
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Affiliation(s)
- Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | | | | | - Shoko Nakamura
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Rena Oka
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Sho Tanaka
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Haruki Imamura
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Yuta Sato
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Hidetoshi Kawana
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Naomi Shimizu
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center
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Hitsumoto T. Clinical Usefulness of the Cardio-Ankle Vascular Index as a Predictor of Primary Cardiovascular Events in Patients With Chronic Kidney Disease. J Clin Med Res 2018; 10:883-890. [PMID: 30425760 PMCID: PMC6225859 DOI: 10.14740/jocmr3631] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 10/12/2018] [Indexed: 12/27/2022] Open
Abstract
Background The cardio-ankle vascular index (CAVI) is a physiologic marker reflecting arterial function. There have been no prospective studies investigating the relationship between CAVI and cardiovascular events in patients with chronic kidney disease (CKD). The aim of this prospective study was to assess the clinical usefulness of CAVI as a predictor of primary cardiovascular events in patients with CKD. Methods The study enrolled 460 outpatients with CKD but no history of cardiovascular disease (152 men and 308 women; mean ± standard deviation age, 74 ± 12 years). Patients were assigned to one of three groups: low (L, CAVI < 9; n = 100), medium (M, CAVI 9 - 10; n = 199), or high (H, CAVI > 10; n = 161). The utility of the CAVI as a predictor of primary cardiovascular events was evaluated. Results During the follow-up period (median 60.1 months), major adverse cardiovascular events (MACE) occurred in 91 cases (L, 8 (8.0%); M, 31 (15.6%); H, 52 (32.3%); P < 0.001, log-rank test). On multivariate Cox regression analysis, the risk for a MACE was significantly higher in group H than in non-group H (hazard ratio, 2.04; 95% confidence interval, 1.31 - 3.02; P < 0.01). A CAVI cut-off of 9.7 yielded the largest area under the curve, 0.701 (95% confidence interval: 0.657 - 0.743, P < 0.001), indicating a sensitivity of 74.0% and a specificity of 59.6% for discriminating between those who did and did not experience a MACE during follow-up. Conclusions The results of this study showed that a high CAVI is a predictor of primary cardiovascular events in patients with CKD.
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Affiliation(s)
- Takashi Hitsumoto
- Hitsumoto Medical Clinic, 2-7-7, Takezakicyou, Shimonoseki City, Yamaguchi, 750-0025, Japan.
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28
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Nagayama D, Watanabe Y, Saiki A, Shirai K, Tatsuno I. Lipid Parameters are Independently Associated with Cardio-Ankle Vascular Index (CAVI) in Healthy Japanese Subjects. J Atheroscler Thromb 2018; 25:621-633. [PMID: 29332863 PMCID: PMC6055041 DOI: 10.5551/jat.42291] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/14/2017] [Indexed: 12/19/2022] Open
Abstract
AIM To investigate the associations of conventional lipid parameters with arterial stiffness assessed by cardio-ankle vascular index (CAVI). METHODS A retrospective cross-sectional study was conducted in 23,257 healthy Japanese subjects (12,729 men and 10,528 women, aged 47.1±12.5 years, body mass index (BMI) 22.9±3.4 kg/m2) who underwent health screening between 2004 and 2006 in Japan. RESULTS Male subjects had significantly higher BMI, CAVI and triglycerides (TG), and lower high-density lipoprotein cholesterol (HDL-C) compared to female subjects. After adjusting for confounders, including gender, age, systolic blood pressure and BMI identified by multiple regression analysis, adjusted CAVI was lower in normolipidemic than in dyslipidemic subjects. Among dyslipidemic subjects, those with hypertriglyceridemia had higher adjusted CAVI. A trend test detected linear relations between adjusted CAVI and all the conventional lipid parameters throughout the entire range of serum levels. After adjusting for confounders, logistic regression models showed that all lipid parameters contributed independently to high CAVI (≥90th percentile). Receiver-operating-characteristic analysis determined reliable cut-off values of 93 mg/dl for TG (area under the curve, AUC= 0.735), 114 mg/dl for low-density lipoprotein cholesterol (AUC=0.614) and 63 mg/dl for HDL-C (AUC=0.728) in predicting high CAVI. These cut-off values were confirmed to independently predict high CAVI in a bivariate logistic regression model. CONCLUSION The present study demonstrated independent contribution of conventional lipid parameters to CAVI, indicating a possible association of lipid parameters with early vascular damage.
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Affiliation(s)
- Daiji Nagayama
- Center of Diabetes and Metabolism, Shin-Oyama City Hospital, Tochigi, Japan
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
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29
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Mestanik M, Jurko A, Spronck B, Avolio AP, Butlin M, Jurko T, Visnovcova Z, Mestanikova A, Langer P, Tonhajzerova I. Improved assessment of arterial stiffness using corrected cardio-ankle vascular index (CAVI 0) in overweight adolescents with white-coat and essential hypertension. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:665-672. [PMID: 29103321 DOI: 10.1080/00365513.2017.1397286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Arterial stiffness is a marker of vascular damage. Although adiposity increases cardiovascular risk, the relationship between paediatric overweight and arterial stiffness is unclear. The study aimed to evaluate the simultaneous effect of hypertension and overweight on arterial stiffness using cardio-ankle vascular index (CAVI) and related novel, theoretically blood pressure (BP)-independent, index CAVI0. CAVI and CAVI0 were measured in 140 adolescent boys (16.0 ± 1.9 years) divided into age-matched groups: normal-weight normotensives, overweight normotensives, overweight white-coat hypertensives, and overweight essential hypertensives. Overweight normotensives had significantly lower CAVI and CAVI0 compared to normal-weight normotensives (4.81 ± 0.64 vs. 5.33 ± 0.66, p < .01; 7.10 ± 0.99 vs. 7.81 ± 1.00, p < .01, respectively). CAVI and CAVI0 in overweight essential hypertensives showed no significant difference compared to normal-weight normotensives and were significantly higher compared to overweight normotensives (5.32 ± 0.77 vs. 4.81 ± 0.64, p < .01; 7.77 ± 1.19 vs. 7.10 ± 0.99, p < .01, respectively). CAVI, but not CAVI0, was associated positively with diastolic pressure (0.022 mmHg-1, p = .002) and negatively with pulse pressure (-0.022 mmHg-1, p = .001), and it was significantly higher in overweight white-coat hypertensives compared to overweight normotensives (5.20 ± 0.63 vs. 4.81 ± 0.64, p < .05). The lowering effect of overweight on arterial stiffness indexed by CAVI and CAVI0 in hypertensive adolescents seems to counterbalance the early arteriosclerotic effect of essential hypertension. The increase in CAVI, but not CAVI0, in overweight white-coat hypertensives could be attributable to residual BP dependence of CAVI, which is not present in CAVI0. Under certain conditions, CAVI0 may offer a clinically relevant improved assessment of arterial stiffness superior to CAVI.
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Affiliation(s)
- Michal Mestanik
- a Biomedical Center Martin , Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU) , Martin , Slovak Republic.,b Department of Physiology , JFM CU , Martin , Slovak Republic
| | | | - Bart Spronck
- d Department of Biomedical Sciences, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , NSW , Australia
| | - Alberto P Avolio
- d Department of Biomedical Sciences, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , NSW , Australia
| | - Mark Butlin
- d Department of Biomedical Sciences, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , NSW , Australia
| | - Tomas Jurko
- e Clinic of Neonatology , JFM CU, University Hospital Martin , Martin , Slovak Republic
| | - Zuzana Visnovcova
- a Biomedical Center Martin , Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU) , Martin , Slovak Republic.,b Department of Physiology , JFM CU , Martin , Slovak Republic
| | - Andrea Mestanikova
- a Biomedical Center Martin , Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU) , Martin , Slovak Republic.,b Department of Physiology , JFM CU , Martin , Slovak Republic
| | - Peter Langer
- f Institute of Scientific Instruments, The Czech Academy of Sciences , Brno , Czech Republic.,g International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Ingrid Tonhajzerova
- a Biomedical Center Martin , Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU) , Martin , Slovak Republic.,b Department of Physiology , JFM CU , Martin , Slovak Republic
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30
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Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Rigo F, Martí R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Ramos R, Gomez-Marcos MA. Adiposity measures and arterial stiffness in primary care: the MARK prospective observational study. BMJ Open 2017; 7:e016422. [PMID: 28963288 PMCID: PMC5623460 DOI: 10.1136/bmjopen-2017-016422] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The cardiovascular risk of obesity is potentially increased by arterial stiffness. OBJECTIVE To assess the relationship of adiposity measures with arterial stiffness in Caucasian adults with intermediate cardiovascular risk. SETTING Six Spanish health centres. PARTICIPANTS We enrolled 2354 adults (age range, 35-74 years; mean age, 61.4±7.7 years, 61.9% male). METHODS This is a cross-sectional study that analyses data from the baseline visit of the improving interMediAte RisK management (MARK) study. The main outcome variables were body mass index (BMI), waist-to-height ratio (WHtR), Clínica Universidad de Navarra-body adiposity estimation (CUN-BAE) body fat percentage and body roundness index (BRI). Vascular function was assessed by the cardio-ankle vascular index (CAVI) with the VaSera device; brachial-ankle pulse wave velocity (baPWV) was determined using a validated equation. RESULTS The mean adiposity measures were a BMI of 29.2±4.4, WHtR of 0.61±0.07, CUN-BAE of 35.7±1.7 and BRI of 5.8±1.7. The mean stiffness measures were a CAVI of 8.8±1.2 and baPWV of 14.9±2.5. In multiple linear regression analyses, all adiposity measures were negatively associated with CAVI and baPWV (p<0.01 for all) after adjustment for possible factors of confusion. The proportion of CAVI variability via the adiposity measures were 5.5% for BMI, 5.8% for CUN-BAE, 3.8% for WHtR and 3.7% for BRI. These were higher among diabetic, obese, younger (≤62 years) and non-hypertensive subjects who had similar activity and sedentary profiles. CONCLUSIONS Adiposity measures are negatively associated with arterial stiffness measures. The percentage of variation in CAVI explained by its relation to the different measures of adiposity ranges from 5.8% (CUN-BAE) to 3.7% (BRI). In the case of baPWV, it oscillates between 0.7% (CUN-BAE and BMI) and 0.1% (WHtR). TRIAL REGISTRATION NUMBER NCT01428934.
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Affiliation(s)
- Leticia Gomez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Luis Garcia-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Maria C Patino-Alonso
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Statistics, University of Salamanca, Salamanca, Spain
| | - Jose I Recio-Rodriguez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Fernando Rigo
- San Agustín Health Center, Illes Balears Health Service (IBSALUT), Palma of Mallorca, Spain
| | - Ruth Martí
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
- Institut d'Investigació Biomèdica of Girona Dr. Josep Trueta (IDBGI), Girona, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodriguez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Jose A Maderuelo-Fernandez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Rafel Ramos
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
- Institut d'Investigació Biomèdica of Girona Dr. Josep Trueta (IDBGI), Girona, Spain
- Departament of Ciències Mèdiques, Universitat de Girona, Girona, Spain
| | - Manuel A Gomez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
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Di Bello V, Fabiani I, Calogero E, Colonna P, Carerj S, Canterin FA, Benedetto F, La Carrubba S, Pugliese NR, Barletta V, Conte L. Clinical Usefulness of Cardio-ankle Vascular Index, Local Artery Carotid Stiffness and Global Longitudinal Strain in Subjects with Cardiovascular Risk Factors. J Cardiovasc Echogr 2017; 27:81-87. [PMID: 28758058 PMCID: PMC5516445 DOI: 10.4103/jcecho.jcecho_10_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Vitantonio Di Bello
- Department of Cardiothoracic, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Iacopo Fabiani
- Department of Cardiothoracic, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Enrico Calogero
- Department of Cardiothoracic, Cisanello Hospital, University of Pisa, Pisa, Italy
| | | | - Scipione Carerj
- G. Martino Hospital, Division of Cardiology, University of Messina, Messina, Italy
| | | | - Frank Benedetto
- Division of Cardiology, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy
| | - Salvatore La Carrubba
- Villa Sofia-Cervello Hospital, Division of General Internal Medicine, Palermo, Italy
| | - Nicola R Pugliese
- Department of Cardiothoracic, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Valentina Barletta
- Department of Cardiothoracic, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Lorenzo Conte
- Department of Cardiothoracic, Cisanello Hospital, University of Pisa, Pisa, Italy
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Imamura H, Yamaguchi T, Nagayama D, Saiki A, Shirai K, Tatsuno I. Resveratrol Ameliorates Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Patients With Type 2 Diabetes Mellitus. Int Heart J 2017; 58:577-583. [PMID: 28701674 DOI: 10.1536/ihj.16-373] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Resveratrol has been reported to have potent anti-atherosclerotic effects in animal studies. However, there are few interventional studies in human patients with atherosclerogenic diseases. The cardio-ankle vascular index (CAVI) reflects arterial stiffness and is a clinical surrogate marker of atherosclerosis. The aim of the present study was to investigate the effect of resveratrol on arterial stiffness assessed by CAVI in patients with type 2 diabetes mellitus (T2DM).In this double-blind, randomized, placebo-controlled study, 50 patients with T2DM received supplement of a 100mg resveratrol tablet (total resveratrol: oligo-stilbene 27.97 mg/100 mg/day) or placebo daily for 12 weeks. CAVI was assessed at baseline and the end of study. Body weight (BW), blood pressure (BP), glucose and lipid metabolic parameters, and diacron-reactive oxygen metabolites (d-ROMs; an oxidative stress marker) were also measured.Resveratrol supplementation decreased systolic BP (-5.5 ± 13.0 mmHg), d-ROMs (-25.6 ± 41.8 U.CARR), and CAVI (-0.4 ± 0.7) significantly (P < 0.05) and decreased BW (-0.8 ± 2.1 kg, P = 0.083) and body mass index (-0.5 ± 0.8 kg/m2, P = 0.092) slightly compared to baseline, while there were no significant changes in the placebo group. Decreases in CAVI and d-ROMs were significantly greater in the resveratrol group than in the placebo group. Multivariate logistic regression analysis identified resveratrol supplementation as an independent predictor for a CAVI decrease of more than 0.5.In conclusion, 12-week resveratrol supplementation may improve arterial stiffness and reduce oxidative stress in patients with T2DM. Resveratrol may be beneficial in preventing the development of atherosclerosis induced by diabetes. However, a large-scale cohort study is required to validate the present findings.
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Affiliation(s)
- Haruki Imamura
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Daiji Nagayama
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Kohji Shirai
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
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Benetos A. Assessment of arterial stiffness in an older population: the interest of the cardio-ankle vascular index (CAVI). Eur Heart J Suppl 2017. [DOI: 10.1093/eurheartj/suw059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Nagayama D, Imamura H, Sato Y, Yamaguchi T, Ban N, Kawana H, Ohira M, Saiki A, Shirai K, Tatsuno I. Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects: a cross-sectional study. Vasc Health Risk Manag 2016; 13:1-9. [PMID: 28053538 PMCID: PMC5189698 DOI: 10.2147/vhrm.s119646] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective The objective of this study is to investigate the association of body mass index (BMI) with arterial stiffness assessed by cardioankle vascular index (CAVI). Subjects and methods A retrospective cross-sectional study was conducted in 23,257 healthy Japanese subjects (12,729 men and 10,528 women, aged 47.1 ± 12.5 years, BMI 22.9 ± 3.4 kg/m2) who underwent health screening between 2004 and 2006 in Japan. Exclusion criteria were current medication use and a past history of cardiovascular disease, hypertension, stroke, diabetes, and nephritis. Results Male subjects showed significantly higher BMI, CAVI, and triglycerides and lower high-density lipoprotein (HDL)-cholesterol compared with female subjects. Next, the subjects were divided into tertiles of BMI: lower, middle, and upper, in a gender-specific manner. After adjusting for confounders including age, systolic blood pressure, and HDL-cholesterol identified by multiple regression analysis, the mean CAVI decreased progressively as BMI tertile increased in both genders. Furthermore, a negative inverse relationship between BMI and adjusted CAVI was observed throughout the BMI distribution. Multivariate logistic regression model for contributors of high CAVI (≥90th percentile) identified obesity (odds ratios (95% confidence interval): 0.804 (0.720–0.899)], older age [15.6 (14.0–17.4)], male gender [2.26 (2.03–2.51)], hypertension [2.28 (2.06–2.54)], impaired fasting glucose [1.17 (1.01–1.37)], and low HDL-cholesterol [0.843 (0.669–1.06)] as independent factors. Conclusion We demonstrated an inverse relationship between CAVI and BMI in healthy Japanese subjects, suggesting that systemic accumulation of adipose tissue per se may lead to a linear decrease of arterial stiffness in nonobese and obese subjects without metabolic disorders.
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Affiliation(s)
- Daiji Nagayama
- Center of Endocrinology and Metabolism, Shin-Oyama City Hospital, Oyama-City; Center of Diabetes, Endocrinology and Metabolism
| | | | - Yuta Sato
- Center of Diabetes, Endocrinology and Metabolism
| | | | - Noriko Ban
- Center of Diabetes, Endocrinology and Metabolism
| | | | | | | | - Kohji Shirai
- Department of Vascular Function, Sakura Medical Center, Toho University, Sakura-City, Japan
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Yeboah K, Antwi DA, Gyan B, Govoni V, Mills CE, Cruickshank JK, Amoah AGB. Arterial stiffness in hypertensive and type 2 diabetes patients in Ghana: comparison of the cardio-ankle vascular index and central aortic techniques. BMC Endocr Disord 2016; 16:53. [PMID: 27680212 PMCID: PMC5041289 DOI: 10.1186/s12902-016-0135-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 09/21/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Diabetes and hypertension increase arterial stiffness and cardiovascular events in all societies studied so far; sub-Saharan African studies are sparse. We investigated factors affecting arterial function in Ghanaians with diabetes, hypertension, both or neither. METHOD Testing the hypothesis that arterial stiffness would progressively increase from controls to multiply affected patients, 270 participants were stratified into those with diabetes or hypertension only, with both, or without either. Cardio-ankle vascular index (CAVI), heart-ankle pulse wave velocity (haPWV), aortic PWV (PWVao) by Arteriograph, aortic and brachial blood pressures (BP), were measured. RESULTS In patients with both diabetes and hypertension compared with either alone, values were higher of CAVI (mean ± SD, 8.3 ± 1.2 vs 7.5 ± 1.1 and 7.4 ± 1.1 units; p < 0.05), PWVao (9.1 ± 1.4 vs 8.7 ± 1.9 and 8.1 ± 0.9 m/s; p < 0.05) and haPWV (8.5 ± 1 vs 7.9 ± 1 and 7.2 ± 0.7 m/s; p < 0.05) respectively. In multivariate analysis, age, having diabetes or hypertension and BMI were independently associated with CAVI in all participants (β = 0.49, 0.2, 0.17 and -0.2 units; p < 0.01, respectively). Independent determinants of PWVao were heart rate, systolic BP and age (β = 0.42, 0.27 and 0.22; p < 0.01), and for haPWV were systolic BP, age, BMI, diabetes and hypertension status (β = 0.46, 0.32, -0.2, 0.2 and 0.11; p < 0.01). CONCLUSION In this sub-Saharan setting with lesser atherosclerosis than the western world, arterial stiffness is significantly greater in patients with coexistent diabetes and hypertension but did not differ between those with either diabetes or hypertension only. Simple, reproducibly measured PWV/CAVI may offer effective and efficient targets for intervention.
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Affiliation(s)
- Kwame Yeboah
- Department of Physiology, School of Biomedical & Allied Health Sciences, University of Ghana, P.O. Box KB 143, Accra, Ghana.
| | - Daniel A Antwi
- Department of Physiology, School of Biomedical & Allied Health Sciences, University of Ghana, P.O. Box KB 143, Accra, Ghana
| | - Ben Gyan
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Virginia Govoni
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - Charlotte E Mills
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - J Kennedy Cruickshank
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - Albert G B Amoah
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
- National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
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Rodriguez AJ, Scott D, Ebeling P. Effect of weight loss induced by energy restriction on measures of arterial compliance: A systematic review and meta-analysis. Atherosclerosis 2016; 252:201-202. [DOI: 10.1016/j.atherosclerosis.2016.06.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 06/28/2016] [Indexed: 01/04/2023]
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Shimizu K, Yamamoto T, Shirai K. Arterial stiffness, as monitored by cardio-ankle vascular index, is affected by obstructive sleep apnea, blood glucose control, and body weight - a case with 8 years follow up. Int Med Case Rep J 2016; 9:231-5. [PMID: 27563259 PMCID: PMC4984825 DOI: 10.2147/imcrj.s113377] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The cardio-ankle vascular index (CAVI) is an indicator of arterial stiffness from the heart to the ankles. The CAVI increases as arteriosclerosis progresses, but it can be decreased by appropriate treatment. There are several risk factors for coronary artery disease, however, the degree of stress caused by each separate risk factor to arteries cannot be assessed. CAVI increases with age and according to the severity of atherosclerosis. We found that CAVI also changes in response to the control of risk factors, which may be associated with the functional stiffness of arteries. CAVI can be a useful indicator of risk control for coronary artery disease. We followed a patient aged 71 years who had diabetes mellitus and obstructive sleep apnea (OSA) by measuring CAVI for 8 years from age 63. He underwent coronary artery bypass grafting due to angina pectoris when he was 63 years old. Before coronary artery bypass grafting, CAVI was 11.8 on the right and 11.5 on the left. Three years later he was found to have OSA and received treatment with continuous positive airway pressure. There was a marked improvement in CAVI after continuous positive airway pressure (age 68; right 10.4, left 10.2). However, following a gradual increase in body weight and worsening of diabetes mellitus, CAVI showed an increasing trend. CAVI decreased with biguanides treatment, but increased again with an increase in body weight. In conclusion, CAVI responded to the patient's conditions including obesity, diabetes mellitus, and OSA. CAVI is not only a marker of arterial stiffness, but can also be a useful indicator of physiological status; it may be effective in total risk control for coronary artery disease.
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Affiliation(s)
- Kazuhiro Shimizu
- Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan
| | - Tomoyuki Yamamoto
- Department of Vascular Function, Toho University Sakura Medical Center, Chiba, Japan; Biological Information Analysis Section, Fukuda Denshi Co., Ltd., Tokyo, Japan
| | - Kohji Shirai
- Department of Vascular Function, Toho University Sakura Medical Center, Chiba, Japan; Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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Shimizu K, Yamamoto T, Takahashi M, Sato S, Noike H, Shirai K. Effect of nitroglycerin administration on cardio-ankle vascular index. Vasc Health Risk Manag 2016; 12:313-9. [PMID: 27536126 PMCID: PMC4977019 DOI: 10.2147/vhrm.s106542] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to clarify the difference between effects of nitroglycerin (NTG) on the functional stiffness in patients with and without coronary artery disease (CAD) using a newly developed stiffness index, cardio-ankle vascular index (CAVI). Subjects and methods The two subject groups in this study were normal controls (n=31) and CAD patients (n=25). The normal controls had no medical history and were not on regular medications. On the other hand, the CAD patients had received various treatments like antihypertensive drugs, hypoglycemic agents, and statins. This study was conducted in CAD patients under medications. After a single sublingual administration of NTG 0.3 mg, CAVI, blood pressure (BP), and heart rate (HR) were measured every 5 minutes for 20 minutes. Comparisons of each parameter before and after taking NTG were evaluated for statistical significance using analysis of variance and post hoc tests. Tukey–Kramer test was used for post hoc comparisons. Results In the normal controls, CAVI significantly decreased from baseline after 5, 10, and 15 minutes (from 6.5±0.9 to 5.2±0.9, 5.5±0.9, and 5.7±0.9, respectively). Systolic BP and HR were not significantly changed. Diastolic BP significantly decreased from baseline after 5 and 10 minutes (from 72±8 to 64±9 and 63±9 mmHg, respectively). On the other hand, CAVI, HR, and diastolic BP were not changed significantly in CAD patients. Systolic BP was significantly decreased from baseline after 5, 10, and 15 minutes (from 147±16 to 131±14, 129±12, and 129±13 mmHg, respectively). In the comparison of the two groups, ΔCAVI was not significantly different between the normal controls and CAD patients (−1.4±0.7 vs −1.4±0.9, −1.1±0.7 vs −1.4±1.0, −0.8±0.7 vs −1.2±1.0, and −0.5±0.7 vs −1.1±1.0 at 5, 10, 15, and 20 minutes, respectively). ΔHR was not significantly different between the two groups. ΔSystolic BP in the CAD patients was significantly higher than in the normal controls at 5, 10, 15, and 20 minutes (normal controls vs CAD; −3±7 vs −10±11, −3±5 vs −10±11, −3±6 vs −13±10, and −1±6 vs −11±10 mmHg, respectively). ΔDiastolic BP in the normal controls was significantly higher than in the CAD patients at 5 and 10 minutes (normal controls vs CAD; −8±6 vs −4±4 and −9±4 vs −6±5 mmHg, respectively). Conclusion After NTG administration, the stiffness of the arteries from the origin of the aorta to the ankle as measured by CAVI decreased in both the normal controls and CAD patients, indicating that the response of arterial smooth muscle cells to nitric oxide is preserved even in CAD patients under medication.
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Affiliation(s)
| | - Tomoyuki Yamamoto
- Department of Vascular Function, Toho University Sakura Medical Center, Chiba; Biological Information Analysis Section, Fukuda Denshi Co., Ltd, Tokyo, Japan
| | | | | | | | - Kohji Shirai
- Department of Vascular Function, Toho University Sakura Medical Center, Chiba
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Clinical assessment of arterial stiffness with cardio-ankle vascular index: theory and applications. J Hypertens 2016; 33:1742-57; discussion 1757. [PMID: 26114836 DOI: 10.1097/hjh.0000000000000651] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Arterial stiffness is often assessed in clinical medicine, because it is not only an important factor in the pathophysiology of blood circulation but also a marker for the diagnosis and the prognosis of cardiovascular diseases. Many parameters have so far been proposed to quantitatively represent arterial stiffness and distensibility, such as pressure-strain elastic modulus (Ep), stiffness parameter (β), pulse wave velocity (PWV), and vascular compliance (Cv). Among these, PWV has been most frequently applied to clinical medicine. However, this is dependent on blood pressure at the time of measurement, and therefore it is not appropriate as a parameter for the clinical evaluation of arterial stiffness, especially for the studies on hypertension. On the contrary, stiffness parameter β is an index reflecting arterial stiffness without the influence of blood pressure. Recently, this parameter has been applied to develop a new arterial stiffness index called cardio-ankle vascular index (CAVI). Although this index is obtained from the PWV between the heart and the ankle, it is essentially similar to the stiffness parameter β, and therefore it does not depend on blood pressure changes during the measurements. CAVI is being extensively used in clinical medicine as a measure for the evaluation of cardiovascular diseases and risk factors related to arteriosclerosis. In the present article, we will explain the theoretical background of stiffness parameter β and the process to obtain CAVI. And then, the clinical utility of CAVI will be overviewed by reference to recent studies.
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Effect of weight loss induced by energy restriction on measures of arterial compliance: A systematic review and meta-analysis. Atherosclerosis 2016; 247:7-20. [DOI: 10.1016/j.atherosclerosis.2016.01.042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 01/13/2016] [Accepted: 01/26/2016] [Indexed: 12/16/2022]
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Chotimol P, Saehuan C, Kumphune S. Correlation between cardio-ankle vascular index and biomarkers of oxidative stress. Scandinavian Journal of Clinical and Laboratory Investigation 2016; 76:105-11. [DOI: 10.3109/00365513.2015.1108453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sato Y, Nagayama D, Saiki A, Watanabe R, Watanabe Y, Imamura H, Yamaguchi T, Ban N, Kawana H, Nagumo A, Ohira M, Endo K, Kurosu T, Tomaru T, Shirai K, Tatsuno I. Cardio-Ankle Vascular Index is Independently Associated with Future Cardiovascular Events in Outpatients with Metabolic Disorders. J Atheroscler Thromb 2016; 23:596-605. [DOI: 10.5551/jat.31385] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Yuta Sato
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Daiji Nagayama
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
- Center of Endocrinology and Metabolism, Shin-Oyama City Hospital
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Rena Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Haruki Imamura
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Noriko Ban
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Hidetoshi Kawana
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Ayako Nagumo
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Kei Endo
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
| | - Takumi Kurosu
- Clinical Physiology Unit, Toho University Sakura Medical Center
| | - Takanobu Tomaru
- Clinical Physiology Unit, Toho University Sakura Medical Center
| | - Kohji Shirai
- Department of Vascular Function, Toho University Sakura Medical Center
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center
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Saiki A, Sato Y, Watanabe R, Watanabe Y, Imamura H, Yamaguchi T, Ban N, Kawana H, Nagumo A, Nagayama D, Ohira M, Endo K, Tatsuno I. The Role of a Novel Arterial Stiffness Parameter, Cardio-Ankle Vascular Index (CAVI), as a Surrogate Marker for Cardiovascular Diseases. J Atheroscler Thromb 2016; 23:155-68. [DOI: 10.5551/jat.32797] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Yuta Sato
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Rena Watanabe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Haruki Imamura
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Noriko Ban
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Hidetoshi Kawana
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Ayako Nagumo
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Daiji Nagayama
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Masahiro Ohira
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Kei Endo
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center
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Wu CF, Liu PY, Wu TJ, Hung Y, Yang SP, Lin GM. Therapeutic modification of arterial stiffness: An update and comprehensive review. World J Cardiol 2015; 7:742-753. [PMID: 26635922 PMCID: PMC4660469 DOI: 10.4330/wjc.v7.i11.742] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/30/2015] [Accepted: 09/28/2015] [Indexed: 02/06/2023] Open
Abstract
Arterial stiffness has been recognized as a marker of cardiovascular disease and associated with long-term worse clinical outcomes in several populations. Age, hypertension, smoking, and dyslipidemia, known as traditional vascular risk factors, as well as diabetes, obesity, and systemic inflammation lead to both atherosclerosis and arterial stiffness. Targeting multiple modifiable risk factors has become the main therapeutic strategy to improve arterial stiffness in patients at high cardiovascular risk. Additionally to life style modifications, long-term ω-3 fatty acids (fish oil) supplementation in diet may improve arterial stiffness in the population with hypertension or metabolic syndrome. Pharmacological treatment such as renin-angiotensin-aldosterone system antagonists, metformin, and 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors were useful in individuals with hypertension and diabetes. In obese population with obstructive sleep apnea, weight reduction, aerobic exercise, and continuous positive airway pressure treatment may also improve arterial stiffness. In the populations with chronic inflammatory disease such as rheumatoid arthritis, a use of antibodies against tumor necrosis factor-alpha could work effectively. Other therapeutic options such as renal sympathetic nerve denervation for patients with resistant hypertension are investigated in many ongoing clinical trials. Therefore our comprehensive review provides knowledge in detail regarding many aspects of pathogenesis, measurement, and management of arterial stiffness in several populations, which would be helpful for physicians to make clinical decision.
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Shirai K, Saiki A, Nagayama D, Tatsuno I, Shimizu K, Takahashi M. The Role of Monitoring Arterial Stiffness with Cardio-Ankle Vascular Index in the Control of Lifestyle-Related Diseases. Pulse (Basel) 2015; 3:118-33. [PMID: 26587461 DOI: 10.1159/000431235] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Arteriosclerosis is a major contributor to cardiovascular diseases. One of the difficulties in controlling those diseases is the lack of a suitable indicator of arteriosclerosis or arterial injury in routine clinical practice. Arterial stiffness was supposed to be one of the monitoring indexes of arteriosclerosis. Cardio-ankle vascular index (CAVI) is reflecting the stiffness of the arterial tree from the origin of the aorta to the ankle, and one of the features of CAVI is independency from blood pressure at a measuring time. When doxazosin, an α1-adrenergic blocker, was administered, CAVI decreased, indicating that arterial stiffness is composed of both organic stiffness and functional stiffness, which reflects the contraction of arterial smooth muscle. CAVI shows a high value with aging and in many arteriosclerotic diseases, and is also high in persons possessing main coronary risk factors such as diabetes mellitus, metabolic syndrome, hypertension and smoking. Furthermore, when the most of those risk factors were controlled by proper methods, CAVI improved. Furthermore, the co-relationship between CAVI and heart function was demonstrated during treatment of heart failure. This paper reviews the principle and rationale of CAVI, and discusses the meaning of monitoring CAVI in following up so-called lifestyle-related diseases and cardiac dysfunction in routine clinical practice.
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Affiliation(s)
- Kohji Shirai
- Department of Vascular Function, Chiba, Japan ; Seijinkai Mihama Hospital, Chiba, Japan
| | | | | | | | - Kazuhiro Shimizu
- Cardiovascular Center, Sakura Hospital, School of Medicine, Toho University, Chiba, Japan
| | - Mao Takahashi
- Cardiovascular Center, Sakura Hospital, School of Medicine, Toho University, Chiba, Japan
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Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Frontera G, Ramos R, Martí R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernández JA, Gomez-Marcos MA. The Association Between the Cardio-ankle Vascular Index and Other Parameters of Vascular Structure and Function in Caucasian Adults: MARK Study. J Atheroscler Thromb 2015; 22:901-11. [PMID: 25994828 DOI: 10.5551/jat.28035] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
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.
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Nagayama D, Yamaguchi T, Saiki A, Imamura H, Sato Y, Ban N, Kawana H, Nagumo A, Shirai K, Tatsuno I. High serum uric acid is associated with increased cardio-ankle vascular index (CAVI) in healthy Japanese subjects: a cross-sectional study. Atherosclerosis 2015; 239:163-8. [PMID: 25617856 DOI: 10.1016/j.atherosclerosis.2015.01.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 01/07/2015] [Accepted: 01/11/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate the association of serum uric acid (SUA) with arterial stiffness assessed by cardio-ankle vascular index (CAVI). METHODS We analyzed the cross-sectional data from 27,360 healthy Japanese subjects (12,910 males and 14,450 females) aged between 20 and 74 years without a past history of heart disease, stroke, hypertension, diabetes, nephritis or gout. We investigated whether SUA was independently associated with CAVI in a gender-specific manner. RESULTS BMI, CAVI, systolic/diastolic BP, GOT, GPT, γ-GTP, triglyceride (TG), creatinine and SUA were higher and HDL-C was lower in males than in females. Next, they were stratified by SUA into 3 groups: lower tertile (T1), middle tertile (T2) and upper tertile (T3) and by gender. CAVI increased progressive with increasing SUA tertile, after adjusting for age, BMI and systolic BP (sBP) identified in multiple regression analysis for CAVI. Multivariate analysis showed that the odds ratios (95% CI) relative to T1 for high CAVI (≥90(th) percentile) were 1.233 (0.928-1.638) in T2 and 1.352 (1.031-1.773) in T3 for males, and 1.133 (0.984-1.303) in T2 and 1.361 (1.098-1.687) in T3 for females, after adjusting for confounders. Furthermore, increase in adjusted CAVI was observed in a lower SUA range in females compared to that observed in males. CONCLUSION We demonstrated an independent correlation between SUA and CAVI, and observed gender difference in the SUA range for increase in CAVI. These results may suggest the need to set different target SUA levels for men and women in anti-hyperuricemic treatment for atherosclerosis prevention.
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Affiliation(s)
- Daiji Nagayama
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan; Center of Endocrinology and Metabolism, Shin-Oyama City Hospital, 1-1-5, Wakagi-cho, Oyama-City, Tochigi 323-0028, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan
| | - Haruki Imamura
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan
| | - Yuta Sato
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan
| | - Noriko Ban
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan
| | - Hidetoshi Kawana
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan
| | - Ayako Nagumo
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan
| | - Kohji Shirai
- Department of Vascular Function, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan
| | - Ichiro Tatsuno
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan.
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Gómez-Marcos MÁ, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Gómez-Sánchez L, Gomez-Sanchez M, Rodríguez-Sanchez E, Maderuelo-Fernandez JA, García-Ortiz L. Cardio-ankle vascular index is associated with cardiovascular target organ damage and vascular structure and function in patients with diabetes or metabolic syndrome, LOD-DIABETES study: a case series report. Cardiovasc Diabetol 2015; 14:7. [PMID: 25853841 PMCID: PMC4299688 DOI: 10.1186/s12933-014-0167-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 12/28/2014] [Indexed: 12/21/2022] Open
Abstract
Background The cardio ankle vascular index (CAVI) is a new index of the overall stiffness of the artery from the origin of the aorta to the ankle. This index can estimate the risk of atherosclerosis. We aimed to find the relationship between CAVI and target organ damage (TOD), vascular structure and function, and cardiovascular risk factors in Caucasian patients with type 2 diabetes mellitus or metabolic syndrome. Methods We included 110 subjects from the LOD-Diabetes study, whose mean age was 61 ± 11 years, and 37.3% were women. Measurements of CAVI, brachial ankle pulse wave velocity (ba-PWV), and ankle brachial index (ABI) were taken using the VaSera device. Cardiovascular risk factors, renal function by creatinine, glomerular filtration rate, and albumin creatinine index were also obtained, as well as cardiac TOD with ECG and vascular TOD and carotid intima media thickness (IMT), carotid femoral PWV (cf-PWV), and the central and peripheral augmentation index (CAIx and PAIx). The Framingham-D’Agostino scale was used to measure cardiovascular risk. Results Mean CAVI was 8.7 ± 1.3. More than half (54%) of the participants showed one or more TOD (10% cardiac, 13% renal; 48% vascular), and 13% had ba-PWV ≥ 17.5 m/s. Patients with any TOD had the highest CAVI values: 1.15 (CI 95% 0.70 to 1.61, p < 0.001) and 1.14 (CI 95% 0.68 to 1.60, p < 0.001) when vascular TOD was presented, and 1.30 (CI 95% 0.51 to 2.10, p = 0.002) for the cardiac TOD. The CAVI values had a positive correlation with HbA1c and systolic and diastolic blood pressure, and a negative correlation with waist circumference and body mass index. The positive correlations of CAVI with IMT (β = 0.29; p < 0.01), cf-PWV (β = 0.83; p < 0.01), ba-PWV (β = 2.12; p < 0.01), CAIx (β = 3.42; p < 0.01), and PAIx (β = 5.05; p = 0.04) remained after adjustment for cardiovascular risk, body mass index, and antihypertensive, lipid-lowering, and antidiabetic drugs. Conclusions The results of this study suggest that the CAVI is positively associated with IMT, cf-PWV, ba-PWV, CAIx, and PAIx, regardless of cardiovascular risk and the drug treatment used. Patients with cardiovascular TOD have higher values of CAVI. Trial registration Clinical Trials.gov Identifier: NCT01065155
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Dobsak P, Soska V, Sochor O, Jarkovsky J, Novakova M, Homolka M, Soucek M, Palanova P, Lopez-Jimenez F, Shirai K. Increased Cardio-ankle Vascular Index in Hyperlipidemic Patients without Diabetes or Hypertension. J Atheroscler Thromb 2015; 22:272-83. [DOI: 10.5551/jat.24851] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Petr Dobsak
- International Clinical Research Center, Department of Cardiovascular Diseases, St. Anne’s University Hospital Brno
- Department of Sports Medicine and Rehabilitation, St. Anne’s Faculty Hospital and Masaryk University of Brno, Czech Republic
| | - Vladimir Soska
- Department of Clinical Biochemistry, St. Anne’s University Hospital of Brno
- Department of Laboratory Methods, Masaryk University of Brno
- International Clinical Research Center, Department of Cardiovascular Diseases, St. Anne’s University Hospital Brno
| | - Ondrej Sochor
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester
- International Clinical Research Center, Department of Cardiovascular Diseases, St. Anne’s University Hospital Brno
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine and Faculty of Science, Masaryk University
| | - Marie Novakova
- Department of Physiology, Faculty of Medicine, Masaryk University of Brno
| | - Martin Homolka
- Department of Management, Mendel University in Brno
- International Clinical Research Center, Department of Cardiovascular Diseases, St. Anne’s University Hospital Brno
| | - Miroslav Soucek
- 2nd Clinic of Internal Medicine, Masaryk University of Brno
- International Clinical Research Center, Department of Cardiovascular Diseases, St. Anne’s University Hospital Brno
| | - Petra Palanova
- Department of Preventive Medicine, Faculty of Medicine, Masaryk University of Brno
| | | | - Kohji Shirai
- Internal Medicine, Sakura Hospital, Medical Center, Toho University
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Laucevičius A, Ryliškytė L, Balsytė J, Badarienė J, Puronaitė R, Navickas R, Solovjova S. Association of cardio-ankle vascular index with cardiovascular risk factors and cardiovascular events in metabolic syndrome patients. Medicina (B Aires) 2015; 51:152-158. [DOI: 10.1016/j.medici.2015.05.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 05/14/2015] [Accepted: 05/20/2015] [Indexed: 11/24/2022] Open
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