10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED

Bart Spronck; Alberto Avolio; Isabella Tan; Mark Butlin; Koen Reesink; Tammo Delhaas

doi:10.1016/j.artres.2016.10.087

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Volume 16, Issue C, December 2016, Pages 73 - 73

10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED

Authors

Bart Spronck², Alberto Avolio², Isabella Tan², Mark Butlin², Koen Reesink¹, Tammo Delhaas¹

¹Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia

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

Available Online 24 November 2016.

DOI: 10.1016/j.artres.2016.10.087 How to use a DOI?
Abstract: Objectives: Arterial stiffness index β and cardio-ankle vascular index (CAVI) are widely accepted to quantify the blood pressure (BP)-independent, intrinsic exponent (β₀) of the BP-diameter relationship. CAVI and β assume an exponential relationship between pressure (P) and diameter (d). We aim (1) to demonstrate that, under this assumption, β and CAVI as currently implemented are inherently BP-dependent and (2) to provide corrected, BP-independent forms of CAVI and β.

Methods and results: In P=P_ref*exp[β₀(d/d_ref−1)], usually reference pressure (P_ref) and reference diameter (d_ref) are substituted with diastolic BP and diameter to accommodate measurements. Consequently, the resulting exponent is not equal to the pressure-independent β₀. CAVI does not only suffer from this reference pressure effect, but also from the approximation of dP/dd.

For example, assuming β₀=7, an increase of systolic/diastolic BP from 110/70 to 170/120 mmHg increased β by 8.1% and CAVI by 14.3%. We derived corrected forms of β and of CAVI (CAVI₀) that did not change with BP and represent the pressure-independent β₀.

To substantiate the BP effect on CAVI in a typical follow-up study, we realistically simulated patients (n=161) before and following BP-lowering treatment (assuming no follow-up change in intrinsic β₀ and therefore in actual P-d relationship). Lowering BP from 160±14/111±11 to 120±15/79±11 mmHg (p<0.001) resulted in a significant CAVI decrease (8.1±2.0 to 7.7±2.1, p=0.008) CAVI₀ did not change (9.8±2.4 and 9.9±2.6, p=0.499).

Conclusions: β and CAVI as currently implemented are inherently BP-dependent, potentially leading to erroneous conclusions in arterial stiffness research. BP-independent forms were derived to overcome this problem.
Open Access: This is an open access article distributed under the CC BY-NC license.

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Journal: Artery Research
Volume-Issue: 16 - C
Pages: 73 - 73
Publication Date: 2016/11/24
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2016.10.087 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - Bart Spronck
AU  - Alberto Avolio
AU  - Isabella Tan
AU  - Mark Butlin
AU  - Koen Reesink
AU  - Tammo Delhaas
PY  - 2016
DA  - 2016/11/24
TI  - 10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED
JO  - Artery Research
SP  - 73
EP  - 73
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.087
DO  - 10.1016/j.artres.2016.10.087
ID  - Spronck2016
ER  -

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