Arterial stiffness in health and disease: The role of cardio–ankle vascular index. Issue 6 (December 2021) - Miyoshi, Toru
Highlights: Arterial stiffness is a determinant of cardiovascular health and organ damage. Cardio–Ankle Vascular Index (CAVI) is a marker of arterial stiffness from the origin of the aorta to the ankle. CAVI is independent of blood pressure changes at the time of measurement. Treatment of cardiovascular risk factors and lifestyle modifications reduce CAVI. A cut-off value of 9.0 can predict patients at a high risk of cardiovascular events. Abstract: Arterial stiffness increases with age, as well as in various pathological states, including obesity, diabetes mellitus, smoking, and dyslipidemia, and it has important consequences for cardiovascular health. Arterial stiffness plays a central role in hemodynamic dysfunction characterized by excess pulsatility; specifically, it leads to heart failure, cerebrovascular disease, and renal failure. Among measures of arterial stiffness, carotid–femoral pulse wave velocity is considered as the reference standard; however, it has not been incorporated into routine clinical practice. Cardio–ankle vascular index (CAVI), which is a marker of arterial stiffness measured from the origin of the aorta to the ankle, was developed in 2004. CAVI is based on stiffness parameter β, which is theoretically independent of blood pressure at the time of measurement. CAVI applies stiffness parameter β to arterial segments between the heart and ankle. The measurement of CAVI is simple and well-standardized, and its reproducibility and accuracy are acceptable. Several studies have demonstrated that CAVI is high in patients with various atherosclerotic risk factors, and treatment of cardiovascular risk factors and lifestyle modifications improve CAVI. Several prospective studies have investigated the association between CAVI and future cardiovascular events in the general population and in patients with cardiovascular risk factors. A cut-off value of 9.0 is proposed for predicting patients at a high risk of cardiovascular events. From this review, it is clear that CAVI may be useful in the prevention of cardiovascular disease. Graphical Abstract: Image, graphical abstract