Artery Research

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.191224.172How 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
© 2019 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
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

[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.
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.191224.172How to use a DOI?
Copyright
© 2019 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
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/).

Cite this article

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  -