P152 Prediction of Death or Heart Failure-related Hospitalizations by Cardio-ankle Vascular Index (CAVI) and CAVI₀

Abstract

Background

Arterial stiffness as measured by carotid-femoral pulse wave velocity (PWV) has been shown to predict cardiovascular events [1]. However, PWV is blood pressure (BP) dependent [2,3] leading to the development of cardio-ankle vascular index (CAVI) as a more blood pressure-independent index [4] that also shows predictive ability in Asian populations [5]. Recently, CAVI was further refined into CAVI₀ [6], removing residual acute blood pressure dependence [7]. The present study aims to assess risk prediction by CAVI and CAVI₀ in a US population.

Methods

We enrolled 156 subjects (94.8% male; 47.7% African-American) with and without heart failure. Subjects underwent arterial stiffness assessments (VaSera 1500 N, Fukuda Denshi Co., Tokyo, Japan). Left (L-CAVI) and right (R-CAVI) measurements were obtained from the device, CAVI₀’s were converted from CAVI’s taking into account CAVI’s scale coefficients [8,9]. We prospectively followed participants for a mean of 2.56 years for the composite endpoint of death or heart failure related hospital admission.

Results

L-CAVI and R-CAVI did not differ significantly (9.80 ± 2.11 vs 9.66 ± 1.92, p = 0.146); neither did L-CAVI₀ and R-CAVI₀ (16.51 ± 5.85 vs 16.15 ± 5.34, p = 0.178). In unadjusted Cox regression, R-CAVI, L-CAVI, and R-CAVI₀ but not L-CAVI₀ predicted outcome (Table 1). After adjustment for age, sex, race, and systolic BP, only right-sided CAVIs and CAVI₀s were predictive.

Discussion

We observed possible body-side differences in prediction using CAVI and CAVI₀. A previous study cross-sectionally reported more pronounced body side differences in heart-to-ankle PWV related to cardiovascular disease [10]; we are unaware of published prospective studies observing this. In conclusion, both R-CAVI and R-CAVI₀ predicted heart-failure related end-points.

Table Cox regression results