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Spronck B, Obeid MJ, Paravathaneni M, et al. Predictive Ability of Pressure-Corrected Arterial Stiffness Indices: Comparison of Pulse Wave Velocity, Cardio-Ankle Vascular Index (CAVI), and CAVI0. Am J Hypertens. 2021;doi: 10.1093/ajh/hpab168.
Spronck, B., Obeid, M. J., Paravathaneni, M., Gadela, N. V., Singh, G., Magro, C. A., Kulkarni, V., Kondaveety, S., Gade, K. C., Bhuva, R., Kulick-Soper, C. M., Sanchez, N., Akers, S., & Chirinos, J. A. (2021). Predictive Ability of Pressure-Corrected Arterial Stiffness Indices: Comparison of Pulse Wave Velocity, Cardio-Ankle Vascular Index (CAVI), and CAVI0. American journal of hypertension, . https://doi.org/10.1093/ajh/hpab168
Spronck, Bart, et al. "Predictive Ability of Pressure-Corrected Arterial Stiffness Indices: Comparison of Pulse Wave Velocity, Cardio-Ankle Vascular Index (CAVI), and CAVI0." American journal of hypertension vol. (2021). doi: https://doi.org/10.1093/ajh/hpab168
Spronck B, Obeid MJ, Paravathaneni M, Gadela NV, Singh G, Magro CA, Kulkarni V, Kondaveety S, Gade KC, Bhuva R, Kulick-Soper CM, Sanchez N, Akers S, Chirinos JA. Predictive Ability of Pressure-Corrected Arterial Stiffness Indices: Comparison of Pulse Wave Velocity, Cardio-Ankle Vascular Index (CAVI), and CAVI0. Am J Hypertens. 2021 Oct 19; doi: 10.1093/ajh/hpab168. Epub 2021 Oct 19. PMID: 34664629.
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Am J Hypertens. 2021 Oct 19; doi: 10.1093/ajh/hpab168. Epub 2021 Oct 19.

Predictive Ability of Pressure-Corrected Arterial Stiffness Indices: Comparison of Pulse Wave Velocity, Cardio-Ankle Vascular Index (CAVI), and CAVI0.

American journal of hypertension

Bart Spronck, Mary Jo Obeid, Mahati Paravathaneni, Naga Vaishnavi Gadela, Gurpreet Singh, Caroline A Magro, Varsha Kulkarni, Soumya Kondaveety, Keerthi Chandrika Gade, Rushik Bhuva, Colin M Kulick-Soper, Nicolas Sanchez, Scott Akers, Julio A Chirinos

Affiliations

  1. Department of Biomedical Engineering, School of Engineering & Applied Science, Yale University, New Haven, CT, USA.
  2. Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
  3. Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
  4. Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
  5. Philadelphia VA Medical Center, Philadelphia, PA, USA.
  6. Cardiovascular Division and Center for Magnetic Resonance and Optical Imaging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

PMID: 34664629 DOI: 10.1093/ajh/hpab168

Abstract

BACKGROUND: Pulse wave velocity (PWV) is blood pressure (BP)-dependent, leading to the development of the BP-corrected metrics cardio-ankle vascular index (CAVI) and CAVI0. We aimed to assess risk prediction by heart-to-ankle PWV (haPWV), CAVI, and CAVI0 in a US population.

METHODS: We included 154 subjects (94.8% male; 47.7% African American) with and without heart failure (HF). Left and right haPWV, CAVI, and CAVI0 were measured with the VaSera 1500N device. We prospectively followed participants for a mean of 2.56 years for the composite endpoint death or HF-related hospital admission (DHFA).

RESULTS: Left and right haPWV, CAVI, and CAVI0 values did not differ significantly. In unadjusted analyses, haPWV (left standardized hazard ratio [HR]=1.51, p=0.007; right HR=1.66, p=0.003), CAVI (left HR=1.45, p=0.001; right HR=1.58, p=0.006), and CAVI0 (left HR=1.39, p=0.022; right HR=1.44, p=0.014) significantly predicted DHFA. Predictive ability showed a decreasing trend from haPWV to CAVI to CAVI0; in line with the increasing amount of BP correction in these metrics. In Cox models, right-sided metrics showed a trend towards stronger predictive ability than left-sided metrics. After adjustment for baseline HF status, the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score, and systolic BP, right haPWV (HR=1.58, p=0.025) and CAVI (HR=1.44, p=0.044), but no other stiffness metrics, remained predictive.

CONCLUSIONS: Although conceptually attractive, BP-corrected arterial stiffness metrics do not offer better prediction of DHFA than conventional arterial stiffness metrics, nor do they predict DHFA independently of systolic BP. Our findings support PWV as the primary arterial stiffness metric for outcome prediction.

© The Author(s) 2021. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.

Keywords: arterial stiffness; prospective observational study; risk prediction

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