P152 Prediction of Death or Heart Failure-related Hospitalizations by Cardio-ankle Vascular Index (CAVI) and CAVI0

Bart Spronck; Jonathan Lee; Garrett Oldland; Mary Jo Obeid; Mahati Paravathaneni; Naga Vaishnavi Gadela; Armghan Ans; Gurpreet Singh; Rushik Bhuva; Scott Akers; Julio Chirinos

doi:10.2991/artres.k.191224.172

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Volume 25, Issue Supplement 1, December 2019, Pages S189 - S190

P152 Prediction of Death or Heart Failure-related Hospitalizations by Cardio-ankle Vascular Index (CAVI) and CAVI0

Authors

Bart Spronck¹^{, 2}, Jonathan Lee³^{, 4}, Garrett Oldland³^{, 4}, Mary Jo Obeid³, Mahati Paravathaneni³, Naga Vaishnavi Gadela³, Armghan Ans³, Gurpreet Singh³^{, 5}, Rushik Bhuva³, Scott Akers⁴, Julio Chirinos⁶

¹Department of Biomedical Engineering, School of Engineering and Applied Science, Yale University, New Haven, CT, USA

²Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands

³Hospital of the University of Pennsylvania. Philadelphia, PA, USA

⁴Philadelphia VA Medical Center. Philadelphia, PA, USA

⁵Rowan University School of Osteopathic Medicine. Stratford, NJ, USA

⁶University of Pennsylvania Perelman School of Medicine. Philadelphia, PA. USA

Available Online 17 February 2020.

DOI

10.2991/artres.k.191224.172 How to use a DOI?

Abstract

Background: Arterial stiffness as measured by carotid-femoral pulse wave velocity (PWV) has been shown to predict cardiovascular events [1]. However, PWV is blood pressure (BP) dependent [2,3] leading to the development of cardio-ankle vascular index (CAVI) as a more blood pressure-independent index [4] that also shows predictive ability in Asian populations [5]. Recently, CAVI was further refined into CAVI₀ [6], removing residual acute blood pressure dependence [7]. The present study aims to assess risk prediction by CAVI and CAVI₀ in a US population.

Methods: We enrolled 156 subjects (94.8% male; 47.7% African-American) with and without heart failure. Subjects underwent arterial stiffness assessments (VaSera 1500 N, Fukuda Denshi Co., Tokyo, Japan). Left (L-CAVI) and right (R-CAVI) measurements were obtained from the device, CAVI₀’s were converted from CAVI’s taking into account CAVI’s scale coefficients [8,9]. We prospectively followed participants for a mean of 2.56 years for the composite endpoint of death or heart failure related hospital admission.

Results: L-CAVI and R-CAVI did not differ significantly (9.80 ± 2.11 vs 9.66 ± 1.92, p = 0.146); neither did L- CAVI₀ and R-CAVI₀ (16.51 ± 5.85 vs 16.15 ± 5.34, p = 0.178). In unadjusted Cox regression, R-CAVI, L-CAVI, and R-CAVI₀ but not L-CAVI₀ predicted outcome (Table 1). After adjustment for age, sex, race, and systolic BP, only right-sided CAVIs and CAVI₀s were predictive.

	n	Standardized HR [95% CI]	p
Unadjusted
L-CAVI	155	1.33 [1.01–1.76]	0.042
R-CAVI	156	1.52 [1.10–2.11]	0.011
L-CAVI₀	155	1.28 [0.97–1.68]	0.078
R-CAVI₀	156	1.39 [1.04–1.87]	0.027
Adjusted for age, sex, race, and systolic BP
L-CAVI	154	1.35 [0.99–1.83]	0.06
R-CAVI	155	1.55 [1.08–2.21]	0.016
L-CAVI₀	154	1.30 [0.95–1.77]	0.10
R-CAVI₀	155	1.39 [1.0´–1.9´]	0.044

s-HR, standardized hazard ratio; CI, confidence interval.

Table

Cox regression results

Discussion: We observed possible body-side differences in prediction using CAVI and CAVI₀. A previous study cross-sectionally reported more pronounced body side differences in heart-to-ankle PWV related to cardiovascular disease [10]; we are unaware of published prospective studies observing this. In conclusion, both R-CAVI and R-CAVI₀ predicted heart-failure related end-points.

Copyright

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

References

[1]C Vlachopoulos, K Aznaouridis, and C Stefanadis, Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis, J Am Coll Cardiol, Vol. 55, 2010, pp. 1318-27.

[2]JC Bramwell, RJS McDowall, and BA McSwiney, The variation of arterial elasticity with blood pressure in man (Part I), Proc R Soc Lond B, Vol. 94, 1923, pp. 450-4.

[3]B Spronck, MH Heusinkveld, FH Vanmolkot, JO Roodt, E Hermeling, T Delhaas, et al., Pressure-dependence of arterial stiffness: potential clinical implications, J Hypertens, Vol. 33, 2015, pp. 330-8.

[4]K Shirai, J Utino, K Otsuka, and M Takata, A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI), J Atheroscler Thromb, Vol. 13, 2006, pp. 101-7.

[5]K Matsushita, N Ding, ED Kim, M Budoff, JA Chirinos, B Fernhall, et al., Cardio-ankle vascular index and cardiovascular disease: Systematic review and meta-analysis of prospective and cross-sectional studies, J Clin Hypertens (Greenwich), Vol. 21, 2019, pp. 16-24.

[6]B Spronck, AP Avolio, I Tan, M Butlin, KD Reesink, and T Delhaas, Arterial stiffness index beta and cardio-ankle vascular index inherently depend on blood pressure but can be readily corrected, J Hypertens, Vol. 35, 2017, pp. 98-104.

[7]M Mestanik, B Spronck, A Jurko, A Mestanikova, T Jurko, M Grendar, et al., Enchanced cardio-ankle vascular index (CAVI0) is experimentally less blood pressure dependent than standard CAVI, J Hypertens, Vol. 37, 2019, pp. e209.

[8]K Takahashi, T Yamamoto, S Tsuda, F Okabe, T Shimose, Y Tsuji, et al., Coefficients in the CAVI equation and the comparison between CAVI with and without the coefficients using clinical data, J Atheroscler Thromb, Vol. 26, 2019, pp. 465-75.

[9]B Spronck, M Mestanik, I Tonhajzerova, A Jurko, I Tan, M Butlin, et al., Easy conversion of cardio-ankle vascular index into CAVI0: influence of scale coefficients, J Hypertens, Vol. 37, 2019, pp. 1913-14.

[10]VK Yeragani, R Kumar, KJ Bar, P Chokka, and M Tancer, Exaggerated differences in pulse wave velocity between left and right sides among patients with anxiety disorders and cardiovascular disease, Psychosom Med, Vol. 69, 2007, pp. 717-22.

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Journal: Artery Research
Volume-Issue: 25 - Supplement 1
Pages: S189 - S190
Publication Date: 2020/02/17
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.2991/artres.k.191224.172 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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ris enw bib

TY  - JOUR
AU  - Bart Spronck
AU  - Jonathan Lee
AU  - Garrett Oldland
AU  - Mary Jo Obeid
AU  - Mahati Paravathaneni
AU  - Naga Vaishnavi Gadela
AU  - Armghan Ans
AU  - Gurpreet Singh
AU  - Rushik Bhuva
AU  - Scott Akers
AU  - Julio Chirinos
PY  - 2020
DA  - 2020/02/17
TI  - P152 Prediction of Death or Heart Failure-related Hospitalizations by Cardio-ankle Vascular Index (CAVI) and CAVI0
JO  - Artery Research
SP  - S189
EP  - S190
VL  - 25
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.191224.172
DO  - 10.2991/artres.k.191224.172
ID  - Spronck2020
ER  -

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