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. 2023 Nov 25;15(11):e49400.
doi: 10.7759/cureus.49400. eCollection 2023 Nov.

High Cardio-Ankle Vascular Index Values in Idiopathic Sudden Sensorineural Hearing Loss Patients Indicate Better Prognosis

Munetaka Ushio  1 , Yoshihisa Kitazawa  2 , Yuya Tamura  3 , Tomoe Yoshida  4 , Michiko Uchiyama  5 , Taro Takanami  1 , Toshitake Tanaka  1 , Yoshihiro Ikemiyagi  6 , Fuyuko Ikemiyagi  6 , Yasushi Ohta  1
Affiliations

High Cardio-Ankle Vascular Index Values in Idiopathic Sudden Sensorineural Hearing Loss Patients Indicate Better Prognosis

Munetaka Ushio et al. Cureus. .

Abstract

Objective: Vascular disorders and viral infections are the presumed etiologies of idiopathic sudden sensorineural hearing loss (ISSNHL) and acute sensorineural hearing loss, with no identifiable cause. However, no clinical test for estimating the extent of vascular involvement in ISSNHL has been reported despite its potential impact on prognosis and treatment. We investigated the correlation between the cardio-ankle vascular index (CAVI), which reflects arterial stiffness and elasticity, and hearing improvement to ascertain its usefulness as an additional indicator of ISSNHL prognosis and etiology.

Methods: We enrolled 182 patients diagnosed with definite ISSNHL. The percentage of mild ISSNHL patients and that of patients experiencing no change were compared between the high-CAVI and low-CAVI groups. Age, initial and final pure-tone average (PTA) values, CAVI, presence or absence of vertigo, and medical histories were retrospectively reviewed and included in univariate and multivariate analyses.

Results: The percentage of mild ISSNHL patients was smaller in the high-CAVI group than in the low-CAVI group, whereas the percentage of patients experiencing no change was smaller in the high-CAVI group than in the low-CAVI group, although patients in the high-CAVI group were significantly older than those in the low-CAVI group. The Cox proportional hazard model revealed that high CAVI, hypertension, younger age, and initial PTA <90 dB were associated with hearing improvement.

Conclusions: ISSNHL in patients with high CAVI was more severe but had a better prognosis than that in those with low CAVI. CAVI may help evaluate diseases of vascular and other etiologies, as well as ISSNHL.

Keywords: cardio-ankle vascular index; cavi; idiopathic sudden sensorineural hearing loss; prognosis; vascular disorders.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Patient eligibility and study flow
MRI, magnetic resonance imaging; CAVI, cardio-ankle vascular stiffness index; ISSNHL, idiopathic sudden sensorineural hearing loss
Figure 2
Figure 2. Correlation between age and CAVI on the unaffected side
A positive linear correlation was noted between age and CAVI on the unaffected side. CAVI: cardio-ankle vascular stiffness index
Figure 3
Figure 3. Correlation between age and CAVI on the affected side
A positive linear correlation was noted between age and CAVI on the affected side. CAVI: cardio-ankle vascular index
Figure 4
Figure 4. Grades of ISSNHL
The percentage of Grade 1 hearing loss in PTAs of ISSNHL was smaller in the high-CAVI group than in the low-CAVI group (p<0.001). ISSNHL: idiopathic sudden sensorineural hearing loss; PTA: pure-tone average; CAVI: cardio-ankle vascular stiffness index
Figure 5
Figure 5. The level of hearing recovery
The percentage of patients experiencing no change was smaller in the high-CAVI group than in the low-CAVI group (p=0.0087). ISSNHL: idiopathic sudden sensorineural hearing loss; PTA: pure-tone average; CAVI: cardio-ankle vascular stiffness index
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