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. 2023 Jul 14;12(14):4685.
doi: 10.3390/jcm12144685.

Characteristics of Preoperative Arteriosclerosis Evaluated by Cardio-Ankle Vascular Index in Patients with Osteoarthritis before Total Knee Arthroplasty

Yoshinori Ishii  1 , Hideo Noguchi  1 , Junko Sato  1 , Ikuko Takahashi  1 , Hana Ishii  2 , Ryo Ishii  3 , Kei Ishii  4 , Kai Ishii  5 , Shin-Ichi Toyabe  6
Affiliations

Characteristics of Preoperative Arteriosclerosis Evaluated by Cardio-Ankle Vascular Index in Patients with Osteoarthritis before Total Knee Arthroplasty

Yoshinori Ishii et al. J Clin Med. .

Abstract

Purpose: Cardiovascular disease (CVD) is a major risk factor for mortality in patients with osteoarthritis, and comorbidities increase postoperative complications after total knee arthroplasty (TKA). Arteriosclerosis plays a main role in hemodynamic dysfunction and CVD; however, arteriosclerosis has not been preoperatively evaluated before TKA using the cardio-ankle vascular index (CAVI). In this study, we evaluated the degree of preoperative arteriosclerosis using the CAVI in patients undergoing TKA, as well as its correlations with several preoperative patient factors.

Methods: Arteriosclerosis was evaluated in 209 consecutive patients (251 knees) with osteoarthritis who underwent TKA at our institution between May 2011 and June 2022. The CAVI was measured in the supine position 1 day before TKA, and the correlations between the CAVI and several clinical factors were analyzed.

Results: The CAVI was normal in 62 knees (25%), borderline in 71 knees (28%), and abnormal in 118 knees (47%). Univariate analysis revealed a moderate positive correlation between preoperative CAVI and age (r = 0.451, p < 0.001) and a weak negative correlation between preoperative CAVI and body weight (r = -0.306, p < 0.001) and body mass index (BMI) (r = -0.319, p < 0.001). Multivariate analysis showed that age (β = 0.349, p < 0.001) and BMI (β = -0.235, p < 0.001) were significantly correlated with preoperative CAVI.

Conclusion: Arteriosclerosis should be carefully managed intraoperatively and postoperatively in patients with osteoarthritis undergoing TKA, particularly in older patients and patients with a low BMI.

Keywords: age; arteriosclerosis; body mass index; cardio-ankle vascular index; osteoarthritis; total knee arthroplasty.

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Conflict of interest statement

The authors declare that they have no competing interest. Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1
Figure 1
Measurement of the cardio-ankle vascular index (CAVI). First, the distance from the origin of the aorta to the ankle was measured with the patient lying in the supine position on a bed at rest. Next, cuffs used to measure blood pressure were wrapped around the right and left upper arms as well as the right and left ankle joints, and a microphone that detects heart sounds was attached to the chest. At the flip of a switch, the instrument automatically measured the pulse wave and blood pressure and calculated the CAVI. The entire measurement took about 15 min, and the test was painless.
Figure 2
Figure 2
Scatterplot of preoperative CAVI and age. The horizontal axis indicates patient age, and the vertical axis indicates the preoperative CAVI. Correlation equation: CAVI = 4.064 + 0.065 × AGE. CAVI, cardio-ankle vascular index.
Figure 3
Figure 3
Scatterplot of preoperative CAVI and BMI. The horizontal axis indicates the BMI, and the vertical axis indicates the preoperative CAVI. Correlation equation: CAVI = 11.445 − 0.099 × BMI, CAVI, cardio-ankle vascular index; BMI, body mass index.
See this image and copyright information in PMC

References

    1. King L.K., Kendzerska T., Waugh E.J., Hawker G.A. Impact of osteoarthritis on difficulty walking: A population-based study. Arthritis Care Res. 2018;70:71–79. doi: 10.1002/acr.23250. - DOI - PubMed
    1. Kendzerska T., Jüni P., King L.K., Croxford R., Stanaitis I., Hawker G.A. The longitudinal relationship between hand, hip and knee osteoarthritis and cardiovascular events: A population-based cohort study. Osteoarthr. Cartil. 2017;25:1771–1780. doi: 10.1016/j.joca.2017.07.024. - DOI - PubMed
    1. Nüesch E., Dieppe P., Reichenbach S., Williams S., Iff S., Jüni P. All cause and disease specific mortality in patients with knee or hip osteoarthritis: Population based cohort study. BMJ. 2011;342:d1165. doi: 10.1136/bmj.d1165. - DOI - PMC - PubMed
    1. Miyoshi T., Ito H. Arterial stiffness in health and disease: The role of cardio-ankle vascular index. J. Cardiol. 2021;78:493–501. doi: 10.1016/j.jjcc.2021.07.011. - DOI - PubMed
    1. Bierma-Zeinstra S.M.A., Waarsing J.H. The role of atherosclerosis in osteoarthritis. Best Pract. Res. Clin. Rheumatol. 2017;31:613–633. doi: 10.1016/j.berh.2018.08.006. - DOI - PubMed

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