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. 2023 Nov 20;15(11):e49151.
doi: 10.7759/cureus.49151. eCollection 2023 Nov.

Higher Cardio-Ankle Vascular Index Values in Patients With Vestibular Neuritis May Indicate a Better Prognosis

Munetaka Ushio  1 , Toshitake Tanaka  1 , Fuyuko Ikemiyagi  2 , Hanako Totsuka  3 , Taro Takanami  1 , Yoshihiro Ikemiyagi  2 , Yoshihisa Kitazawa  4 , Toshiyuki Nomura  5 , Yasushi Ohta  1 , Tomoe Yoshida  6
Affiliations

Higher Cardio-Ankle Vascular Index Values in Patients With Vestibular Neuritis May Indicate a Better Prognosis

Munetaka Ushio et al. Cureus. .

Abstract

Background: The presumed etiology of vestibular neuritis (VN), a sudden onset of spontaneous vertigo without auditory or cranial nerve symptoms, includes viral infections and vascular disorders. However, no clinical test for estimating vascular disorders in VN has been reported. Moreover, estimating the etiology of VN is important to predict the prognosis and select appropriate treatment. This study aimed to evaluate the cardio-ankle vascular index (CAVI), which reflects arterial stiffness and elasticity, as an additional indicator for estimating the prognosis and etiology of VN.

Materials and methods: Among 207 consecutive patients with suspected VN, 88 patients diagnosed with definite VN were enrolled. Age, initial and final percent canal paresis (CP) in the caloric test, CAVI, presence or absence of vestibular-evoked myogenic potential asymmetry, and medical history were evaluated using univariate and multivariate analyses.

Results: Patients with VN with high CAVI had a better prognosis than those with low CAVI. High CAVI was a factor for improvement in percent CP, in addition to younger age and less severe initial percent CP in the Cox proportional hazard model.

Conclusion: CAVI can be an additional indicator for estimating the prognosis and etiology of VN. This indicator can potentially be applied to other diseases, including vascular disorders with other etiologies.

Keywords: arteriosclerosis; cardio-ankle vascular index; cavi; etiology; vascular disorders; vestibular neuritis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Patients’ description
CP: canal paresis, CAVI: cardio-ankle vascular index
Figure 2
Figure 2. Regression of age to CAVI on the unaffected side
Age showed a positive regression to CAVI on the unaffected side (y = 0.055x + 5.32, R² = 0.44, p < 0.001). CAVI: cardio-ankle vascular stiffness index
Figure 3
Figure 3. Regression of age to CAVI on the affected side
Age showed a positive regression to CAVI on the affected side (y = 0.058x + 5.16, R² = 0.51, p < 0.001). CAVI: cardio-ankle vascular stiffness index
Figure 4
Figure 4. The number of moderate and severe VN patients in the low CAVI and high CAVI groups
The number of moderate and severe VN was 17 and 40 patients in the low CAVI group and 8 and 23 patients in the high CAVI group, respectively. The percentage of moderate and severe VN in the high CAVI group was almost the same as that in the low CAVI group (p = 0.69). CAVI: cardio-ankle vascular stiffness index; VN: vestibular neuritis, CP: canal paresis
Figure 5
Figure 5. The number of recovered, improved, and no changed patients in the low CAVI and high CAVI groups
The number of recovered, improved, and no changed patients were 19, 24, and 14 patients in the low CAVI group and 19, 8, and 4 cases in the high CAVI group, respectively. The percentage of each outcome was different (p = 0.04), and the percentage of recovered patients in the high CAVI group was higher than that in the low CAVI group (p = 0.011). CAVI: cardio-ankle vascular stiffness index
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