Comparison of Atherosclerotic Indicators Between Cardio Ankle Vascular Index and Brachial Ankle Pulse Wave Velocity

Background: Aortic pulse wave velocity has been used for evaluating atherosclerosis. Recently, the development of the volume plethysmographic method has made it possible to easily measure the index of the pulse wave velocity. The brachial ankle pulse wave velocity and cardio ankle vascular index are used for estimating the extent of atherosclerosis. The diagnostic usefulness of these indexes in predicting coronary artery disease was examined. Methods: The brachial ankle pulse wave velocity, the cardio ankle vascular index, and the high-sensitivity C-reactive protein were measured in 696 patients who had chest pain and underwent coronary angiography. Measurement values of brachial ankle pulse wave velocity were compared with those of cardio ankle vascular index in terms of the baseline covariates and the number of major coronary vessels involved (vessel disease). Results: The brachial ankle pulse wave velocity was significantly correlated with age, systolic blood pressure, and diastolic blood pressure but not with the high-sensitivity C-reactive protein. The cardio ankle vascular index was correlated only with age and the high-sensitivity C-reactive protein. The average of both brachial ankle pulse wave velocity and cardio ankle vascular index values was greater in 3 vessel disease group than in 0 vessel disease group. The receiver operating characteristic curve showed that the diagnostic accuracy of coronary artery disease was significantly higher in the cardio ankle vascular index than in the brachial ankle pulse wave velocity (area under the curve ± standard error: 0.691 ± 0.025 vs. 0.584 ± 0.026; P < .05). Conclusions: As a means of estimating the extent of atherosclerosis in large arteries, our results show that both brachial ankle pulse wave velocity and cardio ankle vascular index are useful and that cardio ankle vascular index may have some advantages in its application to patients taking blood pressure—lowering medication because of the minimum effect of blood pressure on its measurement values. The cardio ankle vascular index has increased performance over brachial ankle pulse wave velocity in predicting the coronary artery disease.

[1]  A. Seifalian,et al.  Prospective Assessment of Lower-Extremity Peripheral Arterial Disease in Diabetic Patients Using a Novel Automated Optical Device , 2007, Angiology.

[2]  E. Mannarino,et al.  Relation Between Renal Function Within the Normal Range and Central and Peripheral Arterial Stiffness in Hypertension , 2006, Hypertension.

[3]  Kuniaki Otsuka,et al.  A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI). , 2006, Journal of atherosclerosis and thrombosis.

[4]  E. Lakatta,et al.  Elevated Aortic Pulse Wave Velocity, a Marker of Arterial Stiffness, Predicts Cardiovascular Events in Well-Functioning Older Adults , 2005, Circulation.

[5]  J. Sugawara,et al.  Brachial–ankle pulse wave velocity: an index of central arterial stiffness? , 2005, Journal of Human Hypertension.

[6]  Kazuomi Kario,et al.  Reproducibility of arterial stiffness indices (pulse wave velocity and augmentation index) simultaneously assessed by automated pulse wave analysis and their associated risk factors in essential hypertensive patients. , 2004, Hypertension research : official journal of the Japanese Society of Hypertension.

[7]  Tomoyuki Yambe,et al.  Brachio-ankle pulse wave velocity and cardio-ankle vascular index (CAVI). , 2004, Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie.

[8]  D. Levy,et al.  Changes in Arterial Stiffness and Wave Reflection With Advancing Age in Healthy Men and Women: The Framingham Heart Study , 2004, Hypertension.

[9]  C. Meisinger,et al.  C-Reactive Protein Modulates Risk Prediction Based on the Framingham Score: Implications for Future Risk Assessment: Results From a Large Cohort Study in Southern Germany , 2004, Circulation.

[10]  Thomas Weber,et al.  Arterial Stiffness, Wave Reflections, and the Risk of Coronary Artery Disease , 2004, Circulation.

[11]  G. McVeigh,et al.  Arterial stiffness and pulse wave velocity: problems with terminology. , 2004, Circulation.

[12]  H. Seo,et al.  Aortic pulse wave velocity as an independent marker of coronary artery disease , 2004, Blood pressure.

[13]  Ho-Ming Su,et al.  The Validity of Brachial-ankle Pulse Wave Velocity in Predicting Coronary Artery Disease , 2003 .

[14]  Masanori Munakata,et al.  Utility of automated brachial ankle pulse wave velocity measurements in hypertensive patients. , 2003, American journal of hypertension.

[15]  P. Ridker,et al.  Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events☆ , 2003 .

[16]  Nancy R Cook,et al.  C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women , 2003, Circulation.

[17]  S. Laurent,et al.  Aortic Stiffness Is an Independent Predictor of Primary Coronary Events in Hypertensive Patients: A Longitudinal Study , 2002, Hypertension.

[18]  N Rifai,et al.  High-sensitivity C-reactive protein: a novel and promising marker of coronary heart disease. , 2001, Clinical chemistry.

[19]  W. Nichols,et al.  McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles , 1998 .

[20]  R. Langer,et al.  The Correlation between Symptoms and Non-Invasive Test Results in Patients Referred for Peripheral Arterial Disease Testing , 1996, Vascular medicine.

[21]  D Bergqvist,et al.  Non-invasive measurement of pulsatile vessel diameter change and elastic properties in human arteries: a methodological study. , 1993, Clinical physiology.

[22]  M. Bond,et al.  Anatomic correlates of aortic pulse wave velocity and carotid artery elasticity during atherosclerosis progression and regression in monkeys. , 1991, Circulation.

[23]  S. Sasayama,et al.  Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis. , 1989, Circulation.

[24]  J. Hanley,et al.  A method of comparing the areas under receiver operating characteristic curves derived from the same cases. , 1983, Radiology.

[25]  C E Metz,et al.  Critical evaluation of stress testing in the diagnosis of peripheral vascular disease. , 1982, Surgery.

[26]  J. Hanley,et al.  The meaning and use of the area under a receiver operating characteristic (ROC) curve. , 1982, Radiology.

[27]  H. Wolinsky,et al.  Long‐Term Effects of Hypertension on the Rat Aortic Wall and Their Relation to Concurrent Aging Changes: MORPHOLOGICAL AND CHEMICAL STUDIES , 1972, Circulation research.

[28]  I. C. Benson,et al.  STUDIES ON THE ELASTIC PROPERTIES OF HUMAN ISOLATED AORTA. , 1937, The Journal of clinical investigation.

[29]  A. Hill,et al.  The Velocity of the Pulse Wave in Man , 1922 .

[30]  窪薗 琢郎,et al.  Clinical significance and reproducibility of new arterial distensibility index , 2007 .

[31]  Ose,et al.  Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events* , 2002 .