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. 2021 Mar 29:8:631807.
doi: 10.3389/fcvm.2021.631807. eCollection 2021.

Cardio-Ankle Vascular Index Reflects Impaired Exercise Capacity and Predicts Adverse Prognosis in Patients With Heart Failure

Koichiro Watanabe  1 , Akiomi Yoshihisa  1   2 , Yu Sato  1 , Yu Hotsuki  1 , Fumiya Anzai  1 , Yasuhiro Ichijo  1 , Yusuke Kimishima  1 , Tetsuro Yokokawa  1 , Tomofumi Misaka  1   2 , Takamasa Sato  1 , Takashi Kaneshiro  1 , Masayoshi Oikawa  1 , Atsushi Kobayashi  1 , Yasuchika Takeishi  1
Affiliations

Cardio-Ankle Vascular Index Reflects Impaired Exercise Capacity and Predicts Adverse Prognosis in Patients With Heart Failure

Koichiro Watanabe et al. Front Cardiovasc Med. .

Abstract

Aims: We aimed to assess the associations of CAVI with exercise capacity in heart failure (HF) patients. In addition, we further examined their prognosis. Methods: We collected the clinical data of 223 patients who had been hospitalized for decompensated HF and had undergone both CAVI and cardiopulmonary exercise testing. Results: For the prediction of an impaired peak oxygen uptake (VO2) of < 14 mL/kg/min, receiver-operating characteristic curve demonstrated that the cutoff value of CAVI was 8.9. In the multivariate logistic regression analysis for predicting impaired peak VO2, high CAVI was found to be an independent factor (odds ratio 2.343, P = 0.045). We divided these patients based on CAVI: the low-CAVI group (CAVI < 8.9, n = 145) and the high-CAVI group (CAVI ≥ 8.9, n = 78). Patient characteristics and post-discharge cardiac events were compared between the two groups. The high-CAVI group was older (69.0 vs. 58.0 years old, P < 0.001) and had lower body mass index (23.0 vs. 24.1 kg/m2, P = 0.013). During the post-discharge follow-up period of median 1,623 days, 58 cardiac events occurred. The Kaplan-Meier analysis demonstrated that the cardiac event rate was higher in the high-CAVI group than in the low-CAVI group (log-rank P = 0.004). The multivariate Cox proportional hazard analysis revealed that high CAVI was an independent predictor of cardiac events (hazard ratio 1.845, P = 0.035). Conclusion: High CAVI is independently associated with impaired exercise capacity and a high cardiac event rate in HF patients.

Keywords: arterial stiffness; cardio-ankle vascular index; cardiopulmonary exercise testing; heart failure; prognosis.

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Conflict of interest statement

AY and TM belong to the Department of Advanced Cardiac Therapeutics, which is supported by Fukuda-Denshi CO, Ltd. TY and KS belong to the Department of Pulmonary Hypertension, which is supported by ACTELION PHARMA Co, Ltd. These companies are not associated with the contents of the current study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patient flow chart.
Figure 2
Figure 2
Receiver-operating characteristic curve for the prediction of impaired peak VO2 by CAVI.
Figure 3
Figure 3
Accumulated cardiac event rates stratified by CAVI.
Figure 4
Figure 4
Accumulated all-cause mortality stratified by CAVI.
Figure 5
Figure 5
Accumulated ischemic coronary event rates stratified by CAVI.
See this image and copyright information in PMC

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