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Wuttichaipradit C, Yodwut C, Sukhum P, Hengrussamee K, Treesong M, Thiangtham S, Samut B, Tunhasiriwet A, Yingchoncharoen T. CAVI (Cardio-Ankle Vascular Index) as an independent predictor of hypertensive response to exercise. BMC Cardiovasc Disord 2024; 24:165. [PMID: 38504197 PMCID: PMC10949558 DOI: 10.1186/s12872-024-03807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVES Hypertensive response to exercise (HRE) is related to the development of future hypertension, cardiovascular morbidity, and mortality, independent of resting blood pressure. We hypothesized that arterial stiffness as measured by cardio-ankle vascular index (CAVI) could be an independent predictor of HRE. MATERIALS AND METHODS Retrospective chart review of patients participated in the preventive health program at the Bangkok Heart Hospital who underwent both CAVI and treadmill stress testing on the same day between June and December 2018 were performed. Variables for the prediction of HRE were analyzed using univariate analysis, and significant variables were entered into multiple logistic regression. An ROC curve was created to test the sensitivity and specificity of CAVI as a predictor of HRE. RESULTS A total of 285 participants (55.1% female) were enrolled in this study. There were 58 patients (20.4%) who met the HRE definition (SBP > 210 mmHg in males, SBP > 190 mmHg in females, or DBP > 110 mmHg in both males and females), with a mean age of 46.4 12.8 years. In univariate analysis, age, systolic blood pressure at rest, diastolic blood pressure at rest, pulse pressure at rest, diabetes mellitus, hypertension, dyslipidemia, history of beta-blocker, and CAVI results were statistically significant. Multiple logistic regression revealed that CAVI and systolic blood pressure were statistically significant predictors of HRE with OR of 5.8, 95%CI: 2.9-11.7, P < 0.001 and OR 1.07, 95%CI: 1.03-1.10, P = 0.001 respectively. ROC curve analysis of the CAVI revealed an AUC of 0.827 (95%CI: 0.76-0.89, p < 0.001), and the sensitivity and specificity of cut-point CAVI > 8 were 53% and 92%, respectively. CONCLUSION This study demonstrated that CAVI is an independent predictor of hypertensive response to exercise. Additionally, the findings suggest that CAVI > 8 can be a valuable tool in identifying individuals at risk for hypertensive responses during exercise.
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Affiliation(s)
| | - C Yodwut
- Bangkok Heart Hospital, Bangkok, Thailand
| | - P Sukhum
- Bangkok Heart Hospital, Bangkok, Thailand
| | | | - M Treesong
- Bangkok Heart Hospital, Bangkok, Thailand
| | | | - B Samut
- Bangkok Heart Hospital, Bangkok, Thailand
| | | | - T Yingchoncharoen
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Giani A, Micciolo R, Zoico E, Mazzali G, Zamboni M, Fantin F. Cardio-Ankle Vascular Index and Aging: Differences between CAVI and CAVI0. J Clin Med 2023; 12:6726. [PMID: 37959192 PMCID: PMC10647579 DOI: 10.3390/jcm12216726] [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: 09/07/2023] [Revised: 10/03/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Cardio-ankle vascular index (CAVI) and CAVI0 (a mathematical expression derived from CAVI, supposed to be less dependent on blood pressure), can describe arterial stiffness, considering a wide proportion of the arterial tree. The aim of this study was to examine the relationship between CAVI, CAVI0 and aging, looking at the differences between the two arterial stiffness indexes. METHODS A total of 191 patients (68 male, mean age 68.3 ± 14.4 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included and underwent a comprehensive clinical evaluation. CAVI and CAVI0 were obtained for each. RESULTS CAVI0 steeply rises in the elderly age strata, widening the gap between CAVI and CAVI0. An inverse relationship is evident between CAVI0 and DBP in older patients, and CAVI0 is shown to be dependent on age, DBP and age-DBP interaction (R2 = 0.508). Age modifies the effect of DBP on CAVI0, but not on CAVI. CONCLUSIONS The real new findings of our study are that the association between CAVI0 and diastolic blood pressure (DBP) is modified by age, whereas the association between CAVI and DBP is not modified by age. From a clinical point of view, these are very important findings, as DBP decreases with aging, affecting in elderly populations the reliability of CAVI0, which strictly depends on DBP in the formula to calculate it. To monitor the effect of CV therapies, progression of CV diseases and to evaluate clinical outcomes in elderly populations, we suggest using CAVI and not CAVI0.
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Affiliation(s)
- Anna Giani
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37100 Verona, Italy; (A.G.); (M.Z.)
| | - Rocco Micciolo
- Centre for Medical Sciences and Department of Psychology and Cognitive Sciences, University of Trento, 38123 Trento, Italy;
| | - Elena Zoico
- Section of Geriatric Medicine, Department of Medicine, University of Verona, 37100 Verona, Italy; (E.Z.); (G.M.)
| | - Gloria Mazzali
- Section of Geriatric Medicine, Department of Medicine, University of Verona, 37100 Verona, Italy; (E.Z.); (G.M.)
| | - Mauro Zamboni
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37100 Verona, Italy; (A.G.); (M.Z.)
| | - Francesco Fantin
- Section of Geriatric Medicine, Department of Medicine, University of Verona, 37100 Verona, Italy; (E.Z.); (G.M.)
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Tanaka A, Shibata H, Imai T, Yoshida H, Miyazono M, Takahashi N, Fukuda D, Okada Y, Teragawa H, Suwa S, Kida K, Moroi M, Taguchi I, Toyoda S, Shimabukuro M, Tanabe K, Tanaka K, Nangaku M, Node K. Rationale and design of an investigator-initiated, multicenter, prospective, placebo-controlled, double-blind, randomized trial to evaluate the effects of finerenone on vascular stiffness and cardiorenal biomarkers in type 2 diabetes and chronic kidney disease (FIVE-STAR). Cardiovasc Diabetol 2023; 22:194. [PMID: 37525257 PMCID: PMC10391880 DOI: 10.1186/s12933-023-01928-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The overactivation of mineralocorticoid receptor (MR) plays a key pathological role in the progression of cardiovascular and renal diseases by promoting pro-inflammatory and pro-fibrotic signaling. Recently, it has been found that finerenone, a novel nonsteroidal selective MR antagonist, can robustly improve cardiorenal outcomes in patients with type 2 diabetes (T2D) and a wide spectrum of chronic kidney disease (CKD). However, the mechanisms underlying the cardiorenal benefits of finerenone are poorly understood. Further, whether the clinical benefits are mediated by an improvement in vascular stiffness is not confirmed. Therefore, the current study aims to evaluate the effects of finerenone on vascular stiffness as assessed using cardio ankle vascular index (CAVI) and relevant cardiorenal biomarkers in patients with T2D and CKD. METHODS The Effects of Finerenone on Vascular Stiffness and Cardiorenal Biomarkers in Type 2 Diabetes and Chronic Kidney Disease (FIVE-STAR) is an ongoing, investigator-initiated, multicenter, prospective, placebo-controlled, double-blind, randomized clinical trial in Japan. Its target sample size is 100 subjects. Recruitment will be performed from September 2023 to July 2024. After obtaining informed consent, eligible participants with T2D and CKD (25 mL/min/1.73 m2 ≤ estimated glomerular filtration ratio [eGFR] < 90 mL/min/1.73 m2 and 30 mg/g Cr ≤ urinary albumin-to-creatinine ratio [UACR] < 3500 mg/g Cr) will be equally randomized to receive 24-week treatment with either finerenone (starting dose at 10 mg once daily in participants with a baseline eGFR < 60 mL/min/1.73 m2 or at 20 mg once daily in those with a baseline eGFR ≥ 60 mL/min/1.73 m2) or dose-matched placebo. The primary endpoint is the change from baseline in CAVI at 24 weeks. The secondary endpoints are changes from baseline in UACR at 12 and 24 weeks and relevant serum and urinary biomarkers at 24 weeks. As an exploratory endpoint, proteomic analysis using the Olink® Target 96 panels will be also performed. DISCUSSION FIVE-STAR is the first trial evaluating the therapeutic impact of finerenone on vascular stiffness and relevant cardiorenal biomarkers in patients with T2D and CKD. This study will provide mechanistic insights on the clinical benefits of finerenone based on recent cardiovascular and renal outcome trials. Trial registration Unique Trial Number, NCT05887817 ( https://clinicaltrials.gov/ct2/show/NCT05887817 ) and jRCTs021230011 ( https://jrct.niph.go.jp/latest-detail/jRCTs021230011 ).
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Affiliation(s)
- Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Takumi Imai
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | | | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Oita University, Yufu, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroki Teragawa
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
| | - Satoru Suwa
- Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni-Shi, Japan
| | - Keisuke Kida
- Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masao Moroi
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Isao Taguchi
- Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Kengo Tanabe
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Kenichi Tanaka
- Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
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Beros A, Sluyter J, Scragg RKR. Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis. BMJ Open Diabetes Res Care 2023; 11:11/1/e003140. [PMID: 36746528 PMCID: PMC9906264 DOI: 10.1136/bmjdrc-2022-003140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/08/2023] [Indexed: 02/08/2023] Open
Abstract
Evidence is still emerging on the relationships of arterial stiffness with cardiac autonomic neuropathy (CAN) and peripheral neuropathy (PN). To our knowledge no systematic reviews or meta-analyses of these associations have been published. The purpose of our review was to assess the association of arterial stiffness with each type of neuropathy. Medline and Embase were systematically searched for observational studies of arterial stiffness and neuropathy.The systematic review of 60 studies (25 for CAN and 37 for PN), 59 including people with diabetes, showed arterial stiffness overall was higher in people with neuropathy than people without neuropathy. Forty-three studies were included in the meta-analysis. For CAN (19 studies), arterial stiffness was increased in people with neuropathy compared with without, as measured by pulse wave velocity (PWV) (mean difference: 1.32 m/s, 95% CI 0.82 to 1.81, p<0.00001), pulse pressure (PP) (mean difference: 6.25 mmHg, 95% CI 4.51 to 7.99, p<0.00001) or augmentation index (mean difference: 5.52%, 95% CI 3.46 to 7.58, p<0.0001). For PN (26 studies), arterial stiffness was increased in people with neuropathy compared with those without, as measured by PWV (mean difference: 1.22 m/s, 95% CI 0.87 to 1.58, p<0.00001) or PP (mean difference: 4.59 mmHg, 95% CI 2.96 to 6.22, p<0.00001). Only two cohort studies were located so the temporality of the association between arterial stiffness and neuropathy remains unclear. Increased arterial stiffness is associated with CAN and PN.PROSPERO registration number: CRD42019129563.
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Affiliation(s)
- Angela Beros
- School of Population Health, University of Auckland, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - John Sluyter
- School of Population Health, University of Auckland, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Robert Keith Rhodes Scragg
- School of Population Health, University of Auckland, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
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The Correlation of Arterial Stiffness Parameters with Aging and Comorbidity Burden. J Clin Med 2022; 11:jcm11195761. [PMID: 36233629 PMCID: PMC9572768 DOI: 10.3390/jcm11195761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 12/04/2022] Open
Abstract
The aim of the study was to evaluate the relationships between carotid-femoral pulse wave velocity (PVW-cf), cardio-ankle vascular index (CAVI) and CAVI0 (which is a mathematical elaboration of CAVI, theoretically less dependent on blood pressure), age and comorbidity burden. Furthermore, 183 patients (119 female, mean age 67.5 ± 14.3 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included; demographic, clinical and blood analysis data were collected. Charlson Comorbidity Index (CCI), PVW-cf, CAVI and CAVI 0 were obtained. Significant correlations were found between CAVI, CAVI0, PVW-cf and both age (r = 0.698, r = 0.717, r = 0.410, respectively p < 0.001 for all) and CCI, (r = 0.654; r = 0.658; r = 0.448 respectively and p < 0.001 for all), still significant after adjustment for several variables. In a stepwise multiple regression model, considering several variables, CCI was the only predictor of PWV-cf, whereas age and CCI were significant predictors of both CAVI and CAVI 0. In conclusion, all arterial stiffness indexes are associated with CCI and aging; the latter correlation is more evident for CAVI and CAVI 0 than for PVW-cf. Arterial stiffness parameters can complement the characterization of patients affected by a remarkable comorbidity burden across aging; arterial stiffening might mirror the complexity of these individuals.
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Saigusa T, Watanabe K, Hada Y, Ishii K, Kameda W, Susa S, Ishizawa K, Ishihara H. Cardio-ankle vascular index is more closely associated than brachial-ankle pulse wave velocity with arterial damage and risk of cardiovascular disease in patients with diabetes. BMC Cardiovasc Disord 2022; 22:365. [PMID: 35945498 PMCID: PMC9364514 DOI: 10.1186/s12872-022-02800-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 08/02/2022] [Indexed: 11/15/2022] Open
Abstract
Background This study aimed to compare the usefulness of arterial stiffness parameters, cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV), for evaluating arterial damage and risk of cardiovascular disease (CVD) in subjects with diabetes. Methods The study subjects were 277 patients with type 1 or type 2 diabetes. All subjects were evaluated for vascular stiffness using CAVI (n = 154) or baPWV (n = 123). Carotid intima-media thickness (IMT) and the Suita score were also measured because these are established risk factors for future CVD. Associations of both CAVI and baPWV with these established parameters were evaluated in all subjects, and then in 174 subjects with adjustment for covariates by using propensity score matching. Results In all subjects, CAVI and baPWV correlated significantly with both IMT (r = 0.462, P < 0.001, and r = 0.212, P = 0.019, respectively) and the Suita score (r = 0.573, P < 0.001, and r = 0.373, P < 0.001, respectively). The correlation between CAVI and IMT was more significant than that between baPWV and IMT (Z = 2.33, P = 0.020). Similarly, the correlation between CAVI and the Suita score was more significant than that between baPWV and the Suita score (Z = 2.13, P = 0.033). After adjustment by propensity score matching, significant correlations between CAVI and IMT (r = 0.432 P < 0.001) and between CAVI and the Suita score (r = 0.544, P < 0.001) were preserved, though only the association between baPWV and the Suita score was significant (r = 0.289, P = 0.007) while that between baPWV and IMT showed no significance. Again, CAVI showed a significant association with the Suita score than baPWV (Z = 2.02, P = 0.043). Conclusions CAVI is more closely associated than baPWV with arterial damage and risk of CVD in patients with diabetes. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02800-9.
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Affiliation(s)
- Taro Saigusa
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan
| | - Kentaro Watanabe
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan. .,Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan.
| | - Yurika Hada
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Kota Ishii
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Wataru Kameda
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Shinji Susa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Hisamitsu Ishihara
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan
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Cardio-ankle vascular index with renal progression and mortality in high atherosclerosis risk: a prospective cohort study in CORE-Thailand. Clin Exp Nephrol 2021; 26:247-256. [PMID: 34643840 DOI: 10.1007/s10157-021-02149-x] [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: 09/05/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Increased arterial stiffness is linked to markers of endothelial dysfunction and vasculopathy such as albuminuria, vascular calcification, left ventricular hypertrophy and cardiovascular (CV) diseases. Studies of arterial stiffness on renal progression are limited. OBJECTIVE The study aimed to evaluate the association between high cardio-ankle vascular index (CAVI) and renal endpoint and all-cause mortality in a Thai population with high atherosclerosis risk. METHODS A multicenter prospective cohort study was conducted among subjects with high CV risk or established CV diseases in Thailand. Subjects were divided into 3 groups with mean CAVI < 8, 8-8.9, and ≥ 9, respectively. Primary composite outcome consisted of estimated glomerular filtration rate (eGFR) decline over 40%, eGFR less than 15 mL/min/1.73 m2, doubling of serum creatinine, initiation of dialysis and death related to renal causes. The secondary outcomes were all-cause mortality, CV mortality and eGFR decline. RESULTS A total of 4898 subjects (2743 men and 2155 women) were enrolled. Cox proportional hazards model showed a significant relationship of high CAVI (CAVI ≥ 9) and primary composite outcome. Subjects with high CAVI at baseline had a 1.45-fold (95% CI 1.13-1.84) significant risk for the primary composite outcome and 1.72-fold (95% CI 1.12-2.63) risk for all-cause mortality, compared with normal CAVI (CAVI < 8). After stepwise multivariate analysis, the high CAVI group was only positively associated with primary composite outcome. Kaplan-Meier curve of the primary composite outcome and all-cause mortality demonstrated the worst survival in the high CAVI group (log-rank test with P < 0.05). CONCLUSION In a Thai cohort with high atherosclerosis risk, increased arterial stiffness was a risk factor for worsening renal function, including end-stage renal disease and initiation of dialysis.
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Akyüz AR, Şahin S, Çırakoğlu ÖF, Kul S, Turan T, Erkan H. Relation between fragmented QRS complex and cardio-ankle vascular index in asymptomatic subjects. Clin Exp Hypertens 2021; 43:368-372. [PMID: 33626982 DOI: 10.1080/10641963.2021.1890764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Stiffness of large arteries has been related to cardiovascular mortality. Cardio-ankle vascular index (CAVI) is a novel marker of arterial stiffness. Herein, we aimed to study the relationship between fragmented QRS (fQRS) in electrocardiogram and CAVI. METHODS Asymptomatic patients with fQRS and without fQRS were enrolled in the study consecutively. The fQRS complexes were analyzed in the 12-lead electrocardiogram. Arterial stiffness was assessed by using cardio ankle vascular index (CAVI). It was measured by a VaSera VS-1000 CAVI instrument. RESULTS CAVI values of the patients with fQRS was significantly higher compared to those without fQRS (8.625 (7.9-9.2) versus 6.65 (6.7-8.4) p < .001). In a univariate analysis, it was revealed that there was a significant correlation between increased CAVI and fQRS, age, and epicardial fat thickness. Multiple binary logistic regression analysis revealed that age [95% confidence interval (CI): 1,068-1.214, p < .001] and fQRS [95% (CI): 1.766-23.117, p: 0.005] were the independent determinants of increased CAVI values. CONCLUSIONS ECG is a widely and readily available, inexpensive, reproducible technique that can be examined by almost every physician. fQRS values in electrocardiogram may provide a significant predictive value for arterial stiffness in asymptomatic subjects.
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Affiliation(s)
- Ali Rıza Akyüz
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Ömer Faruk Çırakoğlu
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Selim Kul
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Turhan Turan
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Hakan Erkan
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
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Hitsumoto T. Skin Autofluorescence as a Predictor of First Heart Failure Hospitalization in Patients With Heart Failure With Preserved Ejection Fraction. Cardiol Res 2020; 11:247-255. [PMID: 32595810 PMCID: PMC7295560 DOI: 10.14740/cr1097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/19/2020] [Indexed: 02/07/2023] Open
Abstract
Background An autofluorescence (AF) reader can be used to diagnose skin AF non-invasively by measuring local accumulation of advanced glycation end-products. A number of studies have investigated the relationships between skin AF and cardiovascular disease. However, data regarding the usefulness of skin AF as a predictor of chronic heart failure remain limited. This prospective study aimed to elucidate the usefulness of skin AF as a predictor of first heart failure (HF) hospitalization in patients with HF with preserved ejection fraction (HFpEF). Methods A total of 412 outpatients with HFpEF with no history of HF hospitalization were enrolled. Patients were assigned to either the low (group L; skin AF ≤ 2.9 arbitrary units (AU); n = 303) or the high (group H; skin AF ≥ 3.0 AU; n = 109) group according to optimal skin AF cut-off levels determined using receiver operating characteristic curves. Clinical parameters and the usefulness of skin AF as a predictor of first HF hospitalization were evaluated. Results The E/e' ratio as a marker of left ventricular diastolic function was significantly higher in group H patients than in group L patients at baseline (group H, 11.8 ± 3.8; group L, 10.6 ± 3.3; P = 0.002). During the 72.7-month follow-up period, 43 HF cases were hospitalized (group L, 15 cases; group H, 28 cases; P < 0.001, log-rank test). Multivariate Cox regression analyses revealed that group H exhibited a significantly higher risk of first HF hospitalization than did group L (hazard ratio, 2.26; 95% confidence interval, 1.21 - 3.52; P = 0.014). Conclusions The present study demonstrated that skin AF can predict the risk of first HF hospitalization in patients with HFpEF. Prospective studies, including intervention therapies, are required to validate our observations.
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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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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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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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12
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Lamacchia O, Sorrentino MR, Picca G, Paradiso M, Maiellaro P, De Cosmo S. Cardio-ankle vascular index is associated with diabetic retinopathy in younger than 70 years patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 2019; 155:107793. [PMID: 31325539 DOI: 10.1016/j.diabres.2019.107793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 07/08/2019] [Indexed: 01/23/2023]
Abstract
AIMS This study aimed to investigate the relationship between cardio-ankle vascular index (CAVI) and diabetic retinopathy (DR) in Caucasian patients with type 2 Diabetes Mellitus (T2DM). METHODS This was a cross-sectional study of 299 T2DM patients admitted to Endocrine Unit of Foggia. DR was diagnosed using the International Clinical Disease Severity Scale of American Academy of Ophthalmology. The VaSera VS-1500N was used to measure CAVI. Because age is the most powerful determinant of arterial stiffness and affects the progression of DR, we divided the whole sample into two subgroups: above (older) and below (younger) 70 years. RESULTS The mean age of patients was 60.4 ± 12.6 years and the mean CAVI value was 8.6 ± 1.7. In the whole population DR was diagnosed in 74 (24.7%) patients. CAVI value was clearly higher in patients with DR (9.5 ± 1.6) than in those without (8.7 ± 1.7) (P = 0.001) although this difference was not any more significant when adjusted by age and gender (P = 0.067). In the multivariate model taking into account several possible confounders, the correlation between DR and CAVI remained significant only in younger subjects. In the same subgroup we found a significant association between the stages of DR and CAVI (p = 0.019 adjusted by age and gender). CONCLUSIONS This study shows that CAVI is significantly higher in younger patients with DR than in those without, with a relationship between the stages of DR and CAVI in the same subgroup. Physicians should pay attention to sub-clinical macroangiopathy in younger T2DM patients who have DR.
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Affiliation(s)
- Olga Lamacchia
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, via Luigi Pinto, 1, Foggia, Italy.
| | - Maria Rosaria Sorrentino
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, via Luigi Pinto, 1, Foggia, Italy
| | - Giuseppe Picca
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, via Luigi Pinto, 1, Foggia, Italy
| | - Matteo Paradiso
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, via Luigi Pinto, 1, Foggia, Italy
| | - Pasquale Maiellaro
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, via Luigi Pinto, 1, Foggia, Italy
| | - Salvatore De Cosmo
- Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", viale Cappuccini 1, San Giovanni Rotondo (FG), Italy
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Zhang C, Zhong Y, Tian H. Increased cardio-ankle vascular index is independently associated with chronic kidney disease: A cross-sectional study in Chinese patients with type 2 diabetes mellitus. J Diabetes Complications 2019; 33:623-627. [PMID: 31255433 DOI: 10.1016/j.jdiacomp.2019.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/08/2019] [Accepted: 05/11/2019] [Indexed: 02/06/2023]
Abstract
AIMS This cross-sectional study aimed to investigate the association between arterial stiffness and chronic kidney disease (CKD) in Chinese patients with type 2 diabetes mellitus (T2DM). METHODS This study included 1025 patients with T2DM (796 men, 229 women). The cardio-ankle vascular index (CAVI) served as an index to evaluate arterial stiffness. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or urinary albumin-creatine ratio ≥ 30 mg/g. Increased CAVI was defined as a value ≥9. RESULTS The mean CAVI was 8.4 ± 1.2. Among the patients, 314 (40%) had increased CAVI and 229 (22.3%) had CKD. Blood pressure, HbA1c levels, total cholesterol, low-density lipoprotein cholesterol, uric acid and CAVI were higher among patients with CKD than among those without CKD. Patients with increased CAVI were at a 1.82-fold (95% CI, 1.20-2.75; P < 0.001) higher prevalence of CKD after adjusting for other variables. The odds ratio for CKD was 2.69 (95% CI, 1.12-6.47; P = 0.027) in women and 1.62 (95% CI, 1.01-2.61; P = 0.045) in men. CONCLUSION Increased CAVI was independently associated with CKD in patients with T2DM. Further longitudinal studies with large sample sizes are warranted to investigate the effect of CAVI on CKD in patients with T2DM.
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Affiliation(s)
- Chenghui Zhang
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yajun Zhong
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.
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14
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Factors affecting longitudinal changes in cardio-ankle vascular index in a large general population: the Nagahama study. J Hypertens 2019; 36:1147-1153. [PMID: 29584622 DOI: 10.1097/hjh.0000000000001672] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cardio-ankle vascular index (CAVI) has been increasingly used as an index for arterial stiffness. However, the degree of longitudinal changes and factors affecting these changes in CAVI (ΔCAVI) are largely unknown. The aim of this study was to descriptively clarify factors associated with longitudinal ΔCAVI for the precise use of this index in the assessment of arterial stiffness. METHODS Study participants comprised 9501 community residents (53.1 ± 13.3 years), with 8004 patients included in the longitudinal analysis. CAVI was calculated by the transient time interval of arterial waveform measured at four extremities. RESULTS Factors showing a strong association with baseline CAVI (7.38 ± 1.10) included age (β = 0.586), SBP (β = 0.175), and male sex (β = 0.142), whereas BMI showed an inverse association (β = -0.208) (all P < 0.001). During the 1815 ± 135 days follow-up period, CAVI increased by 0.47 ± 0.68. Multivariate analysis identified age (β = 0.508), male sex (β = 0.089), Brinkman index (β = 0.074), and SBP (β = 0.037) as positive determinants, whereas BMI (β = -0.079) and baseline CAVI (β = -0.590) as inverse determinants for ΔCAVI (all P < 0.001). Further data accumulation is needed to determine a reference value of CAVI due to its large population differences. CONCLUSION Several factors were commonly associated with baseline and longitudinal ΔCAVI. These factors should be carefully considered when CAVI is used for the assessment of arterial stiffness.
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Guo F, Zhou T, Tang J, Dong M, Wei Q. Related Risk Factors between Subclinical Carotid Atherosclerosis and Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus in China. Exp Clin Endocrinol Diabetes 2019; 129:283-288. [PMID: 30965364 DOI: 10.1055/a-0865-1754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Abstract
Purpose To analyze the clinical features and related risk factors in diabetic retinopathy (DR) and subclinical atherosclerosis, the micro- and macro-vascular diseases in newly diagnosed type 2 diabetes mellitus (T2DM).
Methods A retrospective study of 435 cases of inpatients with newly diagnosed T2DM from 2013–2017, and compare the 2 types of T2DM related vascular complications.
Results The macro- and microvascular complications are not rare at this stage. Subclinical atherosclerosis was found in 251 subjects (57.7%), which was higher than that of DR (13.1%). In addition, some cases of subclinical atherosclerosis co-existed with DR, suggesting that DR was related with subclinical atherosclerosis (r=0.098, P=0.041). Older age showed a significant association with both subclinical atherosclerosis and DR. Single factor analysis indicated that dyslipidemia was the common risk factor in DR and subclinical atherosclerosis.
Conclusions It should be paid attention to the screening of both DR and subclinical atherosclerosis in each age group of newly diagnosed T2DM. Except for the control of blood glucose, the control of the dyslipidemia is important in the prevention and treatment of the micro- and macro-vascular diseases.
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Affiliation(s)
- Fengqi Guo
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Zhou
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Tang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingxia Dong
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qianping Wei
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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16
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Hitsumoto T. Clinical Impact of Blood Testosterone Concentration on Cardio-Ankle Vascular Index in Female Patients With Type 2 Diabetes Mellitus. Cardiol Res 2019; 10:9-17. [PMID: 30834054 PMCID: PMC6396806 DOI: 10.14740/cr827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 01/07/2019] [Indexed: 12/17/2022] Open
Abstract
Background Information regarding testosterone as a significant risk factor of cardiovascular disease (CVD) in female patients with type 2 diabetes mellitus (DM) is limited. However, some clinical studies reported the importance of cardio-ankle vascular index (CAVI) as a novel physiological marker of arterial function in type 2 DM. This cross-sectional study aimed to elucidate the clinical effects of blood testosterone concentration on CAVI in female patients with type 2 DM. Methods A total of 238 postmenopausal patients including 97 with a history of CVD with type 2 DM (age (mean ± standard deviation (SD)), 73 ± 9 years) were enrolled. CAVI was measured according to the standard technique, and serum total testosterone concentration (T-T) was also measured as a testosterone level marker in vivo. The relationship between CAVI and T-T was evaluated. Results CAVI is significantly higher (CVD vs. non-CVD: 10.2 ± 1.2 vs. 9.2 ± 1.0, P < 0.001), and log-T-T significantly lower (CVD vs. non-CVD: 1.2 ± 0.2 ng/dL vs. 1.5 ± 0.2 ng/dL, P < 0.001) in patients with CVD than those without CVD. CAVI was significantly negatively correlated with log-T-T (r = -0.41; P < 0.001). Furthermore, multiple regression analysis indicated that CVD (β = 0.23; P < 0.001) and log-T-T (β = -0.18; P < 0.01) were selected as independent subordinate variables for CAVI. Conclusions This study showed that T-T was independently inversely associated with CAVI, indicating that low testosterone concentration is a considerable risk factor for the progression of arterial dysfunction in female patients with type 2 DM.
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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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Correlation of systemic arterial stiffness with changes in retinal and choroidal microvasculature in type 2 diabetes. Sci Rep 2019; 9:1401. [PMID: 30718731 PMCID: PMC6361886 DOI: 10.1038/s41598-018-37969-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/11/2018] [Indexed: 11/08/2022] Open
Abstract
This study was conducted to assess whether systemic arterial stiffness, indicated by cardio-ankle vascular index (CAVI), is related to changes in the microvasculature of the retina and choroid in diabetes mellitus (DM). This study included 113 patients with a confirmed diagnosis of type-2 DM. Among them, 18 patients did not have diabetic retinopathy (DR), 71 had non-proliferative DR (NPDR), and 24 had proliferative DR (PDR). The mean CAVI was 7.58 ± 1.41 in no DR, 8.72 ± 1.47 in NPDR, and 8.43 ± 1.25 in PDR group. Of the 113 eyes, 42 (37.2%) were classified as abnormal CAVI group (CAVI ≥ 9). This group had significantly higher cardiac autonomic neuropathy risk index score, decreased central choroidal thickness, and decreased choroidal vascularity index (CVI). Deep foveal avascular zone area was higher in the abnormal CAVI group. After adjustment for possible confounding factors, CAVI showed negative correlation with the CVI (r = -0.247, P = 0.013). In conclusion, there was a significant correlation between arteriosclerosis and choroidal vascular changes in DR. We suggest prompt ophthalmic evaluation in patients with systemic arteriosclerosis. If the ophthalmologist notes advanced DR, the patient should be referred to a cardiovascular clinic for detailed evaluation of systemic arteriosclerosis.
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18
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Nerve conduction velocity is negatively associated with intima-media thickness and brachial-ankle pulse wave velocity in men with type 2 diabetes mellitus. PLoS One 2018; 13:e0209503. [PMID: 30571795 PMCID: PMC6301707 DOI: 10.1371/journal.pone.0209503] [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: 08/22/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022] Open
Abstract
Objective Previous studies suggest that the presence of diabetic peripheral polyneuropathy (DPN) is associated with atherosclerotic diseases; however, little is known about the relationship between diabetic nerve conduction velocity (NCV) versus arterial stiffness and atherosclerosis parameters. Methods The subjects in this study were 292 men with type 2 diabetes mellitus (T2DM). All subjects underwent NCV examination at median and tibial nerves as motor nerve (MCV) as well as median and sural nerves as sensory nerve (SCV). Brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (IMT) were evaluated as arterial stiffness and atherosclerosis parameters. Results Pearson’s correlation coefficient showed that NCV at all sites negatively correlated with baPWV, maximal and mean IMT (IMT-Max and IMT-Mean), and plaque score (all p values p<0.01 at least). Multiple regression analyses adjusted for confounding factors such as age, duration of diabetes, body mass index, HbA1c, fasting C-peptide, systolic blood pressure, HDL-cholesterol, LDL-cholesterol and albuminuria showed that the association of NCV with IMT-Max, ITM-Mean, and plaque score remained significant (all p values p<0.05 at least) except that between SCV at median and IMT-Max. Moreover, SCV at median (forearm) and sural were significantly associated with baPWV (p = 0.023 and p = 0.027, respectively). Conclusion The present study showed that DPN estimated by quantitative NCV is linearly associated with the deterioration of arterial stiffness and atherosclerosis parameters in T2DM independently of various diabetic and atherosclerotic factors.
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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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20
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Hitsumoto T. Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension. J Clin Med Res 2018; 10:928-935. [PMID: 30425766 PMCID: PMC6225855 DOI: 10.14740/jocmr3652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 12/21/2022] Open
Abstract
Background The blood concentration of high-sensitivity cardiac troponin T (hs-cTnT) is a useful biomarker for myocardial injury or the pathogenesis of hypertension. Little is known about the relationship between hemorheology and myocardial injury in patients with hypertension. This cross-sectional study aimed to clarify the clinical impact of hemorheology on subclinical myocardial injury assessed with a microchannel array flow analyzer (MC-FAN) and its impact on hs-cTnT in patients with hypertension. Methods A total of 447 outpatients (men: 181; women: 266; mean age: 65 ± 13 years), with no history of cardiovascular disease, including admission for heart failure, who were undergoing treatment for hypertension, were enrolled. Whole blood passage time (WBPT) as a marker of hemorheology was measured with a MC-FAN, and the relationship between hs-cTnT levels and various clinical parameters, including WBPT, was examined. Results hs-cTnT levels were detected in 400 patients (89.5%). WBPT was significantly higher in patients with detectable hs-cTnT levels than in those with undetectable hs-cTnT levels (60.5 ± 16.8 s versus 50.2 ± 14.2 s, P < 0.001). In patients with detectable hs-cTnT levels, there was a significant positive correlation between WBPT and hs-cTnT level (r = 0.33; P < 0.001). Multiple regression analysis revealed that WBPT was an independent variable when hs-cTnT was a subordinate factor (β = 0.15; P < 0.01). Receiver-operating characteristic curve analysis indicated that a cutoff value for WBPT of 55.6 s yielded the largest area under the curve (0.744; P < 0.001) for discriminating high hs-cTnT levels as ≥ 0.014 ng/mL. Conclusion The results indicate that WBPT is independently associated with hs-cTnT in hypertensive patients with no history of cardiovascular events, suggesting that impairment of hemorheology in small cardiac vessels causes subclinical myocardial injury. In addition, the study suggests that progression of myocardial injury can be prevented by maintaining WBPT at approximately ≤ 55 s.
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Yi D. Letter: Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus ( Diabetes Metab J 2018;42:285-95). Diabetes Metab J 2018; 42:447-448. [PMID: 30362306 PMCID: PMC6202560 DOI: 10.4093/dmj.2018.0185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Dongwon Yi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
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22
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Park SY, Chon S. Response: Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus ( Diabetes Metab J 2018;42:285-95). Diabetes Metab J 2018; 42:449-450. [PMID: 30362307 PMCID: PMC6202567 DOI: 10.4093/dmj.2018.0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- So Young Park
- Department of Medicine, Graduate School of Medicine, Kyung Hee University, Seoul, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
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Haga N, Akaihata H, Hata J, Aikawa K, Yanagida T, Matsuoka K, Koguchi T, Hoshi S, Ogawa S, Kataoka M, Sato Y, Ishibashi K, Suzuki O, Hashimoto Y, Kojima Y. The association between local atherosclerosis of the prostatic artery and benign prostatic enlargement in humans: Putative mechanism of chronic ischemia for prostatic enlargement. Prostate 2018; 78:1001-1012. [PMID: 29786870 DOI: 10.1002/pros.23658] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 05/07/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND To investigate the possible pathogenesis of the benign prostatic enlargement (BPE) induced by local atherosclerosis, the association between local atherosclerosis and prostatic enlargement was investigated, and molecular biological analyses were performed using human prostatectomy specimens. METHODS A total of 69 consecutive patients who underwent robot-assisted radical prostatectomy (RARP) participated in this prospective study. To evaluate actual local atherosclerosis, prostatic arteries were removed during RARP. Microscopic assessment of local atherosclerosis was classified as one of three degrees of narrowing (minimal, moderate, and severe) according to the degree of obstruction of the inner cavity of the prostatic artery. The expressions of several mediators related to chronic ischemia and cell proliferation of the prostate were investigated by immunohistochemistry. RESULTS The median age of the present cohort was 68 (range: 55-75) years. Although there was no relationship between local atherosclerosis and lower urinary symptoms evaluated by questionnaires, local atherosclerosis was significantly more severe in patients who had a history of treatment for benign prostatic hyperplasia (P = 0.02). Prostate size was significantly larger in the severe local atherosclerosis group than in the minimal and moderate local atherosclerosis groups (P < 0.001 and P = 0.03, respectively). Thepositive expression rates of hypoxia-inducible factor (HIF)-1α, malondialdehyde (MDA), transforming growth factor (TGF)-β1 , and basic fibroblast growth factor (bFGF) in the prostate were significantly higher in patients with local atherosclerosis than in patients without local atherosclerosis (all P < 0.01, respectively). CONCLUSIONS In human surgical specimens, there is evidence that local atherosclerosis of the prostatic artery is significantly associated with prostate size. Given the molecular evidence provided in this study, the putative mechanism for this relationship is that chronic ischemia induced upregulation of oxidative stress pathways, leading to BPE.
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Affiliation(s)
- Nobuhiro Haga
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hidenori Akaihata
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junya Hata
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ken Aikawa
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomohiko Yanagida
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kanako Matsuoka
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomoyuki Koguchi
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Hoshi
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Soichiro Ogawa
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masao Kataoka
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuichi Sato
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kei Ishibashi
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Osamu Suzuki
- Departments of Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuko Hashimoto
- Departments of Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshiyuki Kojima
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
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Hitsumoto T. Clinical Significance of Cardio-Ankle Vascular Index as a Cardiovascular Risk Factor in Elderly Patients With Type 2 Diabetes Mellitus. J Clin Med Res 2018; 10:330-336. [PMID: 29511422 PMCID: PMC5827918 DOI: 10.14740/jocmr3364w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 12/21/2022] Open
Abstract
Background The cardio-ankle vascular index (CAVI) is a novel physiological marker of atherosclerosis that reflects systemic arterial stiffness. The aim of this study was to clarify the clinical significance of CAVI as a risk factor for cardiovascular diseases (CVDs) in elderly patients with type 2 diabetes mellitus. Methods This cross-sectional study enrolled 216 elderly (≥ 65 years) outpatients with type 2 diabetes mellitus who were undergoing antidiabetic treatment (96 males and 120 females; mean age, 75 ± 7 years (mean ± standard deviation)). Associations between CAVI and various clinical parameters were examined. Results CAVI was significantly higher in patients with a history of CVD than in those without a history of CVD (10.4 ± 1.4 vs. 9.5 ± 1.0, respectively, P < 0.001). There were significantly positive correlations between CAVI and various clinical parameters, such as skin autofluorescence (r = 0.47, P < 0.001), high-sensitivity cardiac troponin T levels (r = 0.39, P < 0.001), and reactive oxygen metabolite levels (r = 0.28, P < 0.001). Furthermore, multiple regression analyses revealed that these clinical parameters ((skin autofluorescence (β = 0.30, P < 0.001), high-sensitivity cardiac troponin T levels (β = 0.18, P < 0.001), reactive oxygen metabolite levels (β = 0.15, P < 0.01), and a history of CVD (β = 0.19, P < 0.001)) were independent variables when CAVI was used as a subordinate factor. Conclusion Findings of this study indicate that CAVI may be an important CVD risk factor in elderly patients with type 2 diabetes mellitus. Further investigations in a large number of prospective studies, including intervention therapies, are required to validate our results.
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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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Zhao X, Bo L, Zhao H, Li L, Zhou Y, Wang H. Descriptive study of the relationship between the subclinical carotid disease and biomarkers, carotid femoral pulse wave velocity in patients with hypertension. Clin Exp Hypertens 2017; 40:274-280. [PMID: 29227169 DOI: 10.1080/10641963.2017.1368537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- XiaoXiao Zhao
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, China
| | - Liujin Bo
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, China
| | - Hongwei Zhao
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, China
| | - Lihong Li
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, China
| | - Yingyan Zhou
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, China
| | - Hongyu Wang
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, China
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Zhao X, Bo L, Zhao H, Li L, Zhou Y, Wang H. Cardio-ankle vascular index value in dyslipidemia patients affected by cardiovascular risk factors. Clin Exp Hypertens 2017; 40:312-317. [PMID: 29048932 DOI: 10.1080/10641963.2017.1377213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Increased arterial stiffness is an independent cardiovascular risk factor in smokers or patients with diabetes mellitus and hypertension. Cardio-ankle vascular index (CAVI) is an index of arterial stiffness and atherosclerosis. One of the most important risk factors of the causes of atherosclerosis is dyslipidemia(DLP). However, there was a little research about which influence factors such as: hypertension, diabetes mellitus, and smoking could contribute to the atherosclerosis in the subjects withDLP. METHODS A total of 649 subjects with DLP (Male328/Female321) from Vascular Medicine of Peking University Shougang Hospital were examined, with a median age of 66 and 5-95 percentile range 47.0-83.5 years. Fasting plasma glucose (FPG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG) were analyzed by colorimetric enzymatic assays with the use of an auto analyzer (HITACHI-7170, Hitachi, Tokyo, Japan).CAVI was measured by VS-1000 apparatus. RESULTS CAVI correlated significantly with age (p<0.001), Systolic (p<0.001) blood pressure(BP), Total cholesterol (p<0.001), LDL-cholesterol (p<0.001),Triglycerides (p<0.001) . There was no significant difference in CAVI between smokers and non-smokers (p = 0.08) and between statin-treated subjects than in those without statins (p = 0.247). CAVI was significantly higher in subjects with hypertension than in the normotensive group (p<0.001) and in mellitus subjects than in those without mellitus (p<0.001);however, CAVI values adjusted for age was higher only in hypertension than in the normotensive group (p<0.001). CONCLUSIONS Our study demonstrated that CAVI value in DLP patients is not significantly affected by diabetes mellitus and smoking, but is increased by hypertension.
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Affiliation(s)
- XiaoXiao Zhao
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , China
| | - Liujin Bo
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , China
| | - Hongwei Zhao
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , China
| | - Lihong Li
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , China
| | - Yingyan Zhou
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , China
| | - Hongyu Wang
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , China
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Associations Among Cardio-Ankle Vascular Index, Carotid Intima-Media Thickness, and Fibroblast Growth Factor-21 Levels in Kidney Transplant Patients. Transplant Proc 2017; 49:1791-1796. [DOI: 10.1016/j.transproceed.2017.06.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 04/19/2017] [Accepted: 06/16/2017] [Indexed: 12/25/2022]
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Liu J, Liu H, Zhao H, Shang G, Zhou Y, Li L, Wang H. Descriptive study of relationship between cardio-ankle vascular index and biomarkers in vascular-related diseases. Clin Exp Hypertens 2017; 39:468-472. [PMID: 28544855 DOI: 10.1080/10641963.2016.1273946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jinbo Liu
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, P. R. of China
| | - Huan Liu
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, P. R. of China
| | - Hongwei Zhao
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, P. R. of China
| | - Guangyun Shang
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, P. R. of China
| | - Yingyan Zhou
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, P. R. of China
| | - Lihong Li
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, P. R. of China
| | - Hongyu Wang
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, P. R. of China
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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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Ando A, Miyamoto M, Kotani K, Okada K, Nagasaka S, Ishibashi S. Cardio-Ankle Vascular Index and Indices of Diabetic Polyneuropathy in Patients with Type 2 Diabetes. J Diabetes Res 2017; 2017:2810914. [PMID: 28573145 PMCID: PMC5441120 DOI: 10.1155/2017/2810914] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/20/2017] [Accepted: 03/14/2017] [Indexed: 11/22/2022] Open
Abstract
The cardio-ankle vascular index (CAVI) is used to test vascular function and is an arterial stiffness marker and potential predictor of cardiovascular events. This study aimed to analyze the relation between objective indices of diabetic polyneuropathy (DPN) and the CAVI. One hundred sixty-six patients with type 2 diabetes mellitus were included in this study. We used nerve conduction studies (NCSs) and the coefficient of variation of the R-R interval to evaluate DPN. We estimated arteriosclerosis by the CAVI. Simple and multiple linear regression analyses were performed between neuropathy indices and the CAVI. In univariate analysis, the CAVI showed significant associations with sural sensory nerve conduction velocity and median F-wave conduction velocity. Multiple linear regression analysis for the CAVI showed that sural nerve conduction velocity and median F-wave conduction velocity were significant explanatory variables second only to age. In multiple linear regression analysis for sural nerve conduction velocity among neuropathy indices, the CAVI remained the most significant explanatory variable. In multiple linear regression analysis for median nerve F-wave conduction velocity among neuropathy indices, the CAVI remained the second most significant explanatory variable following HbA1c. These results suggest a close relationship between macroangiopathy and DPN.
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Affiliation(s)
- Akihiko Ando
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, Tochigi 329-0498, Japan
- *Akihiko Ando:
| | - Michiaki Miyamoto
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, Tochigi 329-0498, Japan
- Department of Laboratory Medicine, Jichi Medical University, Tochigi 329-0498, Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Centre for Community Medicine, Jichi Medical University, Tochigi 329-0498, Japan
| | - Kenta Okada
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, Tochigi 329-0498, Japan
| | - Shoichiro Nagasaka
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, Tochigi 329-0498, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, Tochigi 329-0498, Japan
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Sumin AN, Bezdenezhnykh NA, Fedorova NV, Shcheglova AV, Indukaeva EV, Artamonova GV. The values of cardio-ankle vascular and ankle-brachial indices in patients with carbohydrate metabolic disorders: The ESSE-RF study in the Kemerovo Region. TERAPEVT ARKH 2016; 88:11-20. [DOI: 10.17116/terarkh2016881211-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aim. To investigate factors associated with pathological cardio-ankle vascular and ankle-brachial indices (CAVI and ABI) in patients with carbohydrate metabolic disorders (CMD). Subjects and methods. A cross-sectional study was conducted in the framework of the multicenter epidemiological study “Epidemiology of Cardiovascular Diseases and Their Risk Factors in the Russian Federation” (ESSE-RF) in March to October 2013. The standard ESSE-RF protocol was extended by an additional study of peripheral arterial stiffness, by estimating CAVI and ABI automatically. A sample of 1619 people was formed in several stages, in which 311 patients with type 2 diabetes mellitus and prediabetes were identified and divided into 3 groups: 1) 41 patients with pathological CAVI values (≥9.0); 2) 241 with normal CAVI (
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32
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Cardoso CRL, Salles GF. Aortic Stiffness as a Surrogate Endpoint to Micro- and Macrovascular Complications in Patients with Type 2 Diabetes. Int J Mol Sci 2016; 17:E2044. [PMID: 27929441 PMCID: PMC5187844 DOI: 10.3390/ijms17122044] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/27/2016] [Accepted: 11/29/2016] [Indexed: 12/22/2022] Open
Abstract
Increased aortic stiffness has been recognized as a predictor of adverse cardiovascular outcomes in some clinical conditions, such as in patients with arterial hypertension and end-stage renal disease, in population-based samples and, more recently, in type 2 diabetic patients. Patients with type 2 diabetes have higher aortic stiffness than non-diabetic individuals, and increased aortic stiffness has been correlated to the presence of micro- and macrovascular chronic diabetic complications. We aimed to review the current knowledge on the relationships between aortic stiffness and diabetic complications, their possible underlying physiopathological mechanisms, and their potential applications to clinical type 2 diabetes management.
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Affiliation(s)
- Claudia R L Cardoso
- Department of Internal Medicine, School of Medicine and University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco 255, Cidade Universitária, Rio de Janeiro-RJ 21941-901, Brazil.
| | - Gil F Salles
- Department of Internal Medicine, School of Medicine and University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco 255, Cidade Universitária, Rio de Janeiro-RJ 21941-901, Brazil.
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Liu J, Liu H, Zhao H, Zhou Y, Li L, Wang H. Relationship between cardio-ankle vascular index and homocysteine in hypertension subjects with hyperhomocysteinemia. Clin Exp Hypertens 2016; 38:652-657. [PMID: 27653661 DOI: 10.1080/10641963.2016.1182183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Arteriosclerosis evaluated by arterial stiffness is the basic pathophysiological change during the development of hypertension. Cardio-ankle vascular index (CAVI) is an index of arterial stiffness. Hyperhomocysteinemia (HHcy) is an independent risk factor for vascular diseases. However, there was little research about the relationship between CAVI and homocysteine (Hcy) in hypertension subjects with HHcy. METHODS A total of 330 subjects (M/F 133/197) from Vascular Medicine of Peking University Shougang Hospital were divided into four groups: control group (group 1, normotensive with normal Hcy, n = 149), hypertension group (group 2, n = 113), HHcy group (group 3, n = 30), and hypertension with HHcy group (group 4, n = 38). CAVI was measured by VS-1000 apparatus. RESULTS Our results showed that CAVI was significantly higher in group 4 than in group 1 and group 2 (8.41 ± 1.08 vs. 7.79 ± 1.14; 8.41 ± 1.08 vs. 7.87 ± 1.02, both p < 0.05, respectively). Positive correlation between CAVI and Hcy was found in the entire study group (r = 0.109, p = 0.049) and hypertension subjects (group 2 + group 4; r = 0.202, p = 0.014). Multivariate analysis showed that Hcy was an independent associating factor of CAVI in all subjects (β = 0.251, p = 0.034). CONCLUSIONS The present study showed that CAVI was significantly higher in hypertension subjects with HHcy compared to hypertension group. There was significant correlation between CAVI and Hcy, indicating the relationship between arterial stiffness and biomarkers in vascular-related diseases.
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Affiliation(s)
- Jinbo Liu
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , P. R. of China
| | - Huan Liu
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , P. R. of China
| | - Hongwei Zhao
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , P. R. of China
| | - Yingyan Zhou
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , P. R. of China
| | - Lihong Li
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , P. R. of China
| | - Hongyu Wang
- a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , P. R. of China
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Sumin AN, Bezdenezhnykh NA, Fedorova NV, Shcheglova AV, Indukaeva EV, Artamonova GV. Factors associated with abnormal cardio-ankle vascular index in patients with type 2 diabetes and prediabetes. DIABETES MELLITUS 2016. [DOI: 10.14341/dm2004112-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aim: The purpose of this study was to examine the phenotypic and genetic characteristics of patients with type 2 diabetes mellitus (T2DM) with different responses to treatment with metformin (MF) in the Novosibirsk region. Materials and methods: We examined 460 patients with T2DM in the Novosibirsk region. Patients were divided into groups according to their HbA1c level: patients who achieved the target HbA1c level during MF therapy (n = 209) and those who did not reach the target HbA1c level (n=251). Genotyping of ATM (rs11212617) was performed using polymerase chain reaction by TaqMan. Results: Patients who achieved the target HbA1c level during MF treatment (good response) were older (61. 1±9. 1 years vs. 57. 4±8. 4 years, p=0. 001), had later onset of diabetes (54. 6 ± 10. 1 years vs. 49. 2±8. 5 years, p = 0. 0001) and shorter duration of diabetes (6. 5±5. 9 years vs. 8. 2±6. 1 years, p=0. 03) compared with those who did not achieve the target HbA1c level. There was no statistically significant association between ATM rs11212617 and achieving the target HbA1c level among all patients [odds ratio (OR)=0. 94, 95% confidence interval = (0. 73–1. 23), p=0. 67] or those with MF monotherapy [OR=0. 90, (0. 65–1. 25), p=0. 54] or combination therapy [OR=1. 02, (0. 72–1. 43), p=0. 92]. There was an effect of age on response to MF therapy in all three groups (all patients: p=0. 001, MF monotherapy group: p=0. 04, combination therapy group: p=0. 0009). In the MF monotherapy group, low dose MF was associated with a good response (p=0. 03), and in the combination therapy group, males were more likely to have a good response (p=0. 003). Patients with genotype C/C or A/C for ATM (rs11212617) compared with those with genotype A/A were more likely to have high levels of triglycerides [2. 33 (1. 52–4. 2) mmol/l, 2. 09 (1. 35–3. 0) mmol/l and 1. 99 (1. 49–3. 21) mmol/l, respectively, p=0. 001], coronary heart disease (CHD) (13. 4%, 13. 4% and 9. 6%, respectively, p=0. 009) and myocardial infarction (7. 8%, 3. 2% and 4. 0%, respectively, p=0. 001). Conclusion: Patients with T2DM who had a good response to MF therapy were older, more likely to be male and had a later onset of T2DM. Genotype C/C for ATM rs11212617 was associated with high triglycerides, CHD and myocardial infarction. ATM rs11212617 was not associated with response to MF therapy in the Novosibirsk region.
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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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Liu Y, Teng X, Zhang W, Zhang R, Liu W. Association between diabetic retinopathy and subclinical atherosclerosis in China: Results from a community-based study. Diab Vasc Dis Res 2015; 12:366-72. [PMID: 26251441 DOI: 10.1177/1479164115591744] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To evaluate the association of diabetic retinopathy with subclinical atherosclerosis in middle-aged and elderly Chinese with type 2 diabetes. METHODS A cross-sectional community-based study was performed among 1607 patients aged 40 years or older in Shanghai. Non-mydriatic digital fundus photography examination was used in diabetic retinopathy detection. Presence of elevated carotid intima-media thickness or carotid plaque was defined as subclinical atherosclerosis. RESULTS The prevalence of diabetic retinopathy was 15.1% in total patients. Patients with diabetic retinopathy were more likely to have elevated carotid intima-media thickness, carotid plaque and subclinical atherosclerosis than those without diabetic retinopathy (37.9% vs 30.7%, 57.6% vs 49.6% and 64.6% vs 57.1%, respectively). The presence of diabetic retinopathy was significantly associated with increased odds of subclinical atherosclerosis (odds ratio = 1.93, 95% confidence interval = 1.03-3.60) after full adjustments. CONCLUSION The presence of diabetic retinopathy was significantly associated with subclinical atherosclerosis in middle-aged and elderly patients with type 2 diabetics in China.
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Affiliation(s)
- Yu Liu
- Department of Endocrinology, Renji Hospital South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiangyu Teng
- Department of Endocrinology, Renji Hospital South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wei Zhang
- Meilong Health Center, Shanghai, China
| | | | - Wei Liu
- Department of Endocrinology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Yabe M, Haga N, Ogawa S, Kataoka M, Akaihata H, Sato Y, Hata J, Ishibashi K, Kojima Y. Atherosclerosis as a predictor of delayed recovery from lower urinary tract dysfunction after robot-assisted laparoscopic radical prostatectomy. Neurourol Urodyn 2015; 35:920-925. [PMID: 26297155 DOI: 10.1002/nau.22824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/16/2015] [Indexed: 11/10/2022]
Abstract
AIMS The aim of the present study was to investigate whether atherosclerosis could be associated with lower urinary tract dysfunction in the early postoperative period after robot-assisted laparoscopic radical prostatectomy (RARP). METHODS Eighty consecutive patients undergoing RARP were investigated. The severity of atherosclerosis was evaluated by the cardio-ankle vascular index (CAVI) before RARP. Patients were divided into two groups, the atherosclerotic group (CAVI ≥9.0) and the control group (CAVI <9.0). International Prostate Symptom Score (IPSS), quality of life (QOL) index, uroflowmetry, post-void residual urine volume (PVR), frequency-volume charts, and the 1-hr pad test were compared between the two groups. Assessments were performed before RARP, and then at 1, 3, and 6 months after RARP. RESULTS Preoperative subjective and objective parameters were not significantly different between the two groups. The voiding symptom score of the IPSS and the QOL index was significantly higher in the atherosclerotic group at 3 months after RARP (P = 0.035, P = 0.001, respectively). The maximum flow rate was consistently lower in the atherosclerotic group, reaching a significant difference at 6 months after RARP (P = 0.027). IPSS total and storage symptom scores, PVR, frequency, and urine loss were not significantly different between the groups after RARP. CONCLUSIONS Atherosclerosis delayed the improvement of both voiding symptoms and voiding function after RARP, leading to aggravation of QOL in the early postoperative period. Atherosclerosis may be a predictor of slower recovery from transient lower urinary tract dysfunction immediately after RARP. Neurourol. Urodynam. 35:920-925, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Michihiro Yabe
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nobuhiro Haga
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Soichiro Ogawa
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masao Kataoka
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hidenori Akaihata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuichi Sato
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junya Hata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kei Ishibashi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
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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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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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Szczyrba S, Kozera GM, Neubauer-Geryk J, Wolnik B, Nyka WM, Bieniaszewski L. Diabetic symmetric polyneuropathy is associated with increased aortal stiffening but not cerebral angiopathy in type 1 diabetes. J Diabetes Complications 2015; 29:73-6. [PMID: 25456818 DOI: 10.1016/j.jdiacomp.2014.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 09/22/2014] [Accepted: 10/02/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Diabetic symmetric polyneuropathy (DSP) and cerebral microangiopathy are common complications of type 1 diabetes (T1DM). However, little is known about associations between DSP, cerebral microcirculation and macrovascular injury in T1DM. We aimed to assess relationships between those complications. MATERIAL AND METHODS We examined 42 patients (25 females; mean age 37.1±5.6years) with T1DM (mean disease duration 20.6±6.1years). DSP was diagnosed with the use of quantitative vibration sensory testing (QVST) and Michigan Neuropathy Screening Instrument (MNSI). Cerebral microvasculature was evaluated with measurements of vasomotor reactivity reserve (VMR) and pulsatility index (PI) of middle cerebral artery, macroangiopathic injury by measuring intima-media complex thickness (IMT) in the common carotid artery and carotid-femoral pulse-wave velocity (PWV). RESULTS Patients with DSP (33.3%) showed higher PWV than those without DPS (10.5 vs 9.1m/s; P=0.03); no differences concerning VMR, PI or IMT existed. There were correlations between PWV and vibration perception thresholds (VPT) (r=0.44; P=0.004) and MNSI score (r=0.43; P=0.003); VPT showed impact on PWV (beta 0.34; P<0.03). CONCLUSIONS DSP is associated with systemic macroangiopathy, reflected by increased carotid-femoral PWV, but not with the cerebral macro- and microangiopathy.
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Affiliation(s)
| | - Grzegorz M Kozera
- Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Bogumił Wolnik
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | - Walenty M Nyka
- Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland
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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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Wang H, Liu J, Zhao H, Zhou Y, Zhao X, Song Y, Li L, Shi H. Relationship between cardio-ankle vascular index and N-terminal pro-brain natriuretic peptide in hypertension and coronary heart disease subjects. ACTA ACUST UNITED AC 2014; 8:637-43. [DOI: 10.1016/j.jash.2014.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 05/23/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
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Relationship between cardio-ankle vascular index and plasma lipids in hypertension subjects. J Hum Hypertens 2014; 29:105-8. [PMID: 24831100 DOI: 10.1038/jhh.2014.37] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/26/2014] [Accepted: 04/02/2014] [Indexed: 12/17/2022]
Abstract
An increasing of arterial stiffness is the path physiological characteristic of hypertension. Cardio-ankle vascular index (CAVI) is a new index of arterial stiffness. In the present study, we investigated the relationship between CAVI and plasma lipids in hypertension subjects. A total of 542 subjects (male/female 336/206) from the Department of Vascular Medicine were divided into two groups: healthy group (n=402) and hypertension group (n=140). CAVI was measured with VS-1000 apparatus. Our results showed that the levels of CAVI, body mass index (BMI), fast blood glucose (FBG), uric acid (UA) and triglycerides (TGs) were significantly higher in the hypertension group than in the control group (all P<0.01). High-density lipoprotein cholesterol (HDL-C) was significantly lower in the hypertension group than in the control group (P<0.001). CAVI was positively correlated with FBG, UA, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and TG in the entire study group. Negative correlation between CAVI and HDL-C was found in the entire group even after adjusting for age, gender and blood pressure. In addition, there was negative correlation between CAVI and HDL-C in the control group. However, there was negative relational tendency between CAVI and HDL-C in hypertension subjects without significant difference. Multiple linear regression analysis showed that age, BMI, FBG, TG and heart rate were independent associating factors of CAVI in all subjects. Age, FBG and Cr were independent associating factors of CAVI in the hypertension group. Our present study showed that CAVI was significantly higher in hypertension subjects, and metabolic accompaniments might involve the increasing of arterial stiffness in hypertension patients.
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Urine 6-sulfatoxymelatonin levels are inversely associated with arterial stiffness in post-menopausal women. Maturitas 2014; 78:117-22. [PMID: 24780409 DOI: 10.1016/j.maturitas.2014.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 03/23/2014] [Accepted: 03/26/2014] [Indexed: 11/21/2022]
Abstract
OBJECT The secretion of melatonin, a pleiotropic hormone mainly synthesized by the pineal gland, typically decreases with age and may be associated with the development of aging-related pathologic conditions such as cardiovascular disease. Atherosclerosis is an aging-related disease, the pathogenesis of which involves chronic inflammation and increased oxidative stress. Since melatonin has both anti-oxidant and anti-inflammatory properties, it may be associated with atherosclerosis. Therefore, we investigated the relationship between urine concentrations of 6-sulfatoxymelatonin (aMT6s) and arterial stiffness in post-menopausal women. METHODS A total of 66 post-menopausal women participated in the study. Melatonin secretion was estimated by measuring aMT6s levels in first morning urine samples. The cardio-ankle vascular index (CAVI) was used as an indicator of arterial stiffness. RESULTS Estimated mean CAVI decreased gradually with increasing aMT6s quartiles. The multivariate logistic regression analysis showed that the fourth aMT6s quartile was associated with a high CAVI with an adjusted odds ratio of 0.03 (95% confidence interval, 0.01-0.47). CONCLUSION Our study revealed an inverse relationship between urine aMT6s and arterial stiffness as determined by CAVI. Although it is impossible to determine causality, our results suggest that melatonin may have a beneficial role in the pathogenesis of atherosclerosis. Further prospective studies are required to establish the clinical significance of our study.
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Wang H, Shirai K, Liu J, Lu N, Wang M, Zhao H, Xie J, Yu X, Fu X, Shi H, Li L. Comparative study of cardio-ankle vascular index between Chinese and Japanese healthy subjects. Clin Exp Hypertens 2014; 36:596-601. [DOI: 10.3109/10641963.2014.897715] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Homma S, Kato K, Hayashi J, Yamamoto M. Negative associations between arterial stiffness parameter evaluated by cardio-ankle vascular index and serum low-density lipoprotein cholesterol concentration in early-stage atherosclerosis. Angiology 2014; 66:143-9. [PMID: 24402322 DOI: 10.1177/0003319713516853] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The cardio-ankle vascular index (CAVI), calculated values from cardio-ankle pulse wave velocity and blood pressure, corresponds predominantly to the stiffness of the aorta and peripheral arteries of the lower limbs. However, the reported associations between CAVI and serum low-density lipoprotein cholesterol (LDL-C) levels remain inconsistent. A cross-sectional study of 1878 consecutive patients (mean age: 59.2 years) who underwent general health checkup showed a negative association between CAVI and serum LDL-C or non-high-density lipoprotein cholesterol (non-HDL-C) concentrations with age-adjusted correlation and multiple regression analysis. Using the similar analyses divided by the status of risk factors and degree of maximum carotid intima-media thickness (maxIMT), negative correlations between CAVI and LDL-C or non-HDL-C levels were observed only in nonrisk groups including nondiabetics patients or patients with maxIMT <1.0 mm, in those with expected low extent of advanced atherosclerotic lesions. In contrast, such a correlation was not found in each comparable risk-loaded group.
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Affiliation(s)
- Satoki Homma
- Department of General Medicine, School of Medicine, Kyorin University, Tokyo, Japan
| | - Kiyoe Kato
- Center of General Health Check-Up, Saiseikai Central Hospital, Tokyo, Japan
| | - Junichi Hayashi
- Department of General Medicine, School of Medicine, Kyorin University, Tokyo, Japan
| | - Minoru Yamamoto
- Department of General Medicine, School of Medicine, Kyorin University, Tokyo, Japan
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Alberto EC, Tanigawa T, Maruyama K, Kawasaki Y, Eguchi E, Mori H, Yoshimura K, Tanno S, Sakurai S, Hitsumoto S, Saito I. Relationships between Nocturnal Intermittent Hypoxia, Arterial Stiffness and Cardiovascular Risk Factors in a Community-based Population: The Toon Health Study. J Atheroscler Thromb 2014; 21:1290-7. [DOI: 10.5551/jat.24505] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Suzuki J, Kurosu T, Kon T, Tomaru T. Impact of Cardiovascular Risk Factors on Progression of Arteriosclerosis in Younger Patients: Evaluation by Carotid Duplex Ultrasonography and Cardio-Ankle Vascular Index(CAVI). J Atheroscler Thromb 2014. [DOI: 10.5551/jat.20438] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Wang H, Liu J, Zhao H, Fu X, Shang G, Zhou Y, Yu X, Zhao X, Wang G, Shi H. Arterial stiffness evaluation by cardio-ankle vascular index in hypertension and diabetes mellitus subjects. ACTA ACUST UNITED AC 2013; 7:426-31. [PMID: 23871571 DOI: 10.1016/j.jash.2013.06.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 06/09/2013] [Accepted: 06/14/2013] [Indexed: 01/09/2023]
Abstract
Arterial stiffness is an independent predictor for vascular diseases. Cardio-ankle vascular index (CAVI) is a new index of arterial stiffness. In the present study, we investigated the possible risk factors involving CAVI in hypertension and diabetes mellitus (DM) subjects. One thousand sixty-three subjects (M/F 533/530) from Shougang Corporation Examination Center were divided into four groups: healthy group (n = 639); hypertension group (n = 312); DM group (n = 58); and hypertension with DM group (n = 54). CAVI was measured by VS-1000 apparatus. Our results showed that CAVI was significantly higher in hypertension subjects with DM than in healthy and hypertension group, respectively (8.59 ± 1.08 vs 7.23 ± 1.10; 8.59 ± 1.08 vs 7.94 ± 1.33; both P < .05). CAVI was positively correlated with age, systolic blood pressure, diastolic blood pressure, pulse pressure, fasting plasma glucose, HbA1c, uric acid, total cholesterol, triglycerides in the entire group (r = 0.633, 0.280, 0.172, 0.269, 0.209, 0.254, 0.176, 0.129, 0.175; all P < .05, respectively). There was negatively correlation between CAVI and high-density lipoprotein cholesterol in the entire group (r = -0.167; P < .05). Multivariate analysis showed that age, body mass index, HbA1c, and high-density lipoprotein cholesterol were independent associating factors of CAVI in all subjects (β = 0.699; P < .001, β = -0.189; P = .001, β = 0.144; P = .015, β = -0.136; P = .019, respectively). Our present study suggested that CAVI was significantly higher in hypertension subjects with DM compared with healthy and hypertension groups.
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Affiliation(s)
- Hongyu Wang
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China.
| | - Jinbo Liu
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China
| | - Hongwei Zhao
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China
| | - Xiaobao Fu
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China
| | - Guangyun Shang
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China
| | - Yingyan Zhou
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China
| | - Xiaolan Yu
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China
| | - Xujing Zhao
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China
| | - Guang Wang
- Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, Peoples' Republic of China
| | - Hongyan Shi
- Department of Vascular Medicine, Peking University Shougang Hospital, Beijing 100144, Peoples' Republic of China
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