What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Coronary risk factors (hypertension, dyslipidemia, hyperglycemia) (n=32627). Intervention: CAVI without coefficients (haβ) vs. CAVI (with coefficients). Primary outcome: Discrepancy in statistically significant differences between CAVI and haβ among subjects with or without risk factors.

December 3, 2018Open Access

Coefficients in the CAVI Equation and the Comparison Between CAVI With and Without the Coefficients Using Clinical Data

TKTakahashi KojiChiba University TYTomoyuki YamamotoWaseda University STShinichi TSUDAKyushu University

Key Result

There was no discrepancy in the statistical significance of differences between CAVI and haβ when comparing subjects with and without coronary risk factors, nor during changes following nitroglycerin administration.

Study Design

Type

Cross-Sectional (n=32,627)

Multicenter

Yes

Structured PICO

Does CAVI without coefficients (haβ) perform similarly to standard CAVI in differentiating cardiovascular risk factors and responding to nitroglycerin?

Population

32,627 adults aged 20 to 74 years undergoing physical health checks, categorized by the presence or absence of coronary risk factors, to compare the CAVI and haβ arterial stiffness indices.

Exposure

Measurement of Cardio-Ankle Vascular Index (CAVI) and CAVI without coefficients (haβ); sublingual administration of nitroglycerin 0.3 mg in the acute clinical study.

Comparator

Healthy subjects vs. subjects with coronary risk factors (hypertension, dyslipidemia, hyperglycemia, abnormal ECG) in the epidemiological study; baseline vs. post-nitroglycerin values in the clinical study.

Outcome

Statistical significance of differences between CAVI and haβ among subjects with or without risk factors, and during changes following nitroglycerin administration over a 20-min period.surrogate

CAVI and haβ (CAVI without coefficients) demonstrate equivalent clinical validity as indices of arterial stiffness, supporting the use of haβ in segmental arterial stiffness research.

Limitations

The adjustment of haβ to H-PWV required dividing the data into three sections because haβ is based on PWV squared whereas H-PWV is based solely on PWV, making it difficult to maintain high correlation across a wide range with one approximate adjustment.

Abstract

AIM: The Cardio-Ankle Vascular Index (CAVI) is a stiffness index of the arterial tree from the origin of the aorta to the ankle, independent of blood pressure at the time of measurement. The CAVI equation includes the coefficients "a" and "b" to adjust it to the value of Hasegawa's pulse wave velocity, which is compensated for at 80 mmHg of diastolic pressure. To verify this adjustment with the coefficients, the clinical significance of CAVI and CAVI without the coefficients (haβ) were compared in both an epidemiological study and an acute clinical study. METHODS: In the epidemiological study, the significances of CAVI and haβ among people with or without coronary risks such as hypertension, dyslipidemia, hyperglycemia, and abnormal electrocardiography change, were compared. In the acute clinical study, nitroglycerin was administered to subjects in a control group and to coronary artery disease patients, observing CAVI and haβ values over a 20-min period. RESULTS: There was no discrepancy in terms of statistically significant differences between CAVI and haβ among subjects with or without risk factors. Furthermore, there was also no discrepancy in terms of statistically significant differences between CAVI and haβ during the changes of those values following nitroglycerin administration over a 20-min period. CONCLUSION: In both the epidemiologic and clinical studies, there was no discrepancy in terms of significant differences between CAVI and haβ. These results suggest that both are valid as indices of stiffness of the arterial tree from the origin of the aorta to the ankle.

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