P152 Prediction of Death or Heart Failure-related Hospitalizations by Cardio-ankle Vascular Index (CAVI) and CAVI0

• Published in: Artery research Vol. 25; no. 1
• Main Authors: Bart Spronck, Jonathan Lee, Garrett Oldland, Mary Jo Obeid, Mahati Paravathaneni, Naga Vaishnavi Gadela, Armghan Ans, Gurpreet Singh, Rushik Bhuva, Scott Akers, Julio Chirinos
• Format: Journal Article
• Language: English
• Published: BMC 01.02.2020
• ISSN: 1876-4401
• DOI: 10.2991/artres.k.191224.172

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. TableCox regression results 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. 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.