2015


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2015/№3

EchoCG data in ihd patients with different cardio-ankle vascular indexes

Sumin A. N., Osokina A. V., Shcheglova A. V., Verkoshanskaya E. M., Barbarash O. L.
Federal State Budgetary Institution "Research Institute for Complex Issues of Cardiovascular Diseases" at the Siberian Branch of the Russian Academy of Medical Sciences, Sosnovy Bulvar 6, Kemerovo 65000

Keywords: vascular stiffness, CAD, cardio-ankle vascular index, EchoCG

DOI: 10.18087/rhj.2015.3.1973

Background. Arterial stiffness is an integral index of the arterial wall condition. For this reason, this index has been extensively used in cardiological practice and considered one of RFs for cardiovascular diseases (CVD). Parameters of arterial stiffness have been reported to be related with impaired LV diastolic function. Aim. To evaluate parameters of systolic and diastolic heart function in IHD patients with different values of the cardio-ankle vascular index (CAVI). Materials and methods. The study included 744 patients with stable IHD forms who were being prepared for elective surgical myocardial revascularization. Exclusion criteria were ACS within less than one month; atrial fibrillation rhythm; and the brachial-ankle index <0.9. The group for analysis consisted of 374 patients (50.3 %). Volume sphygmography was performed using the VaSera-1000 instrument (Fukuda Denschi, Japan). Based on CAVI values, patients were divided into three groups: group I (n=141), patients with normal CAVI (<8.0), group II (n=129), patients with intermediate CAVI (≥8 and ≤9.0), and group III (n=104), patients with abnormal CAVI (>9.0). The groups were compared by clinico-historical and laboratory data, results of EchoCG, color duplex scanning of brachiocephalic arteries (BCA) and lower limb arteries, and coronary angiography (CAG). Results. The groups differed in age (р=0.000), presence of arterial hypertension (AH) (р=0.002), AH duration (р=0.017), smoking status (р=0.002), and type 2 diabetes mellitus (DM) (р=0.029). The rate of BCA stenosis was significantly higher in patients of groups III and II than in group I. The highest percentage of BCA stenosis was observed in group III; group I significantly differed from group II, and group II significantly differed from group III. Two coronary vessels were affected more frequently in IHD patients with normal and intermediate CAVI values and less frequently in patients with abnormal CAVI. Correlation analysis showed significant correlations of CAVI with left atrial dimensions and LV myocardial mass index. Conclusion. In patients with stable IHD, normal CAVI values were observed in 37.7 % of cases, intermediate in 34.5 % of cases, and abnormal in 27.8 % of cases. Patients with abnormal CAVI were older and had higher rates of AH, DM, and stenosis of non-coronary arteries. The presence of abnormal CAVI was associated with increased left atrial dimensions, aortic diameter, myocardial mass index, and LV relative thickness.
  1. Ishisone T, Koeda Y, Tanaka F et al. Comparison of utility of arterial stiffness parameters for predicting cardiovascular events in the general population. Int Heart J. 2013;54 (3):160–5.
  2. Mohammed M, Zito C, Cusmà-Piccione M et al. Arterial stiffness changes in patients with cardiovascular risk factors but normal carotid intima-media thickness. J Cardiovasc Med (Hagerstown). 2013 Sep;14 (9):622–8.
  3. Daemen J. Diastolic dysfunction and arterial stiffness: the chicken or the egg. Neth Heart J. 2013 May;21 (5):219–21.
  4. Kim H, Kim HS, Yoon HJ et al. Association of cardio-ankle vascular index with diastolic heart function in hypertensive patients. Clin Exp Hypertens. 2014;36 (4):200–5.
  5. Takami T, Saito Y. Azelnidipine plus olmesartan versus amlodipine plus olmesartan on arterial stiffness and cardiac function in hypertensive patients: a randomized trial. Drug Des Devel Ther. 2013 Mar 22;7:175–83.
  6. Zhang C, Ohira M, Iizuka T et al. Cardio-ankle vascular index relates to left ventricular ejection fraction in patients with heart failure. A retrospective study. Int Heart J. 2013;54 (4):216–21.
  7. Shirai K, Utino J, Saiki A et al. Evaluation of blood pressure control using a new arterial stiffness parameter, cardio-ankle vascular index (CAVI). Curr Hypertens Rev. 2013 Feb;9 (1):66–75.
  8. Sakane K, Miyoshi T, Doi M et al. Association of new arterial stiffness parameter, the cardio-ankle vascular index, with left ventricular diastolic function. J Atheroscler Thromb. 2008 Oct;15 (5):261–8.
  9. Miao DM, Ye P, Xiao WK et al. Influence of low high-density lipoprotein cholesterol on arterial stiffening and left ventricular diastolic dysfunction in essential hypertension. J Clin Hypertens (Greenwich). 2011 Oct;13 (10):710–5.
  10. Xu L, Jiang CQ, Lam TH et al. Arterial stiffness and left-ventricular diastolic dysfunction: Guangzhou Biobank Cohort Study-CVD. J Hum Hypertens. 2011 Mar;25 (3):152–8.
  11. Mizuguchi Y, Oishi Y, Miyoshi H et al. Impact of statin therapy on left ventricular function and carotid arterial stiffness in patients with hypercholesterolemia. Circ J. 2008 Apr;72 (4):538–44.
  12. Masugata H, Senda S, Goda F et al. Tissue Doppler echocardiography for predicting arterial stiffness assessed by cardio-ankle vascular index. Tohoku J Exp Med. 2009 Feb;217 (2):139–46.
  13. Kim HL, Im MS, Seo JB et al. The association between arterial stiffness and left ventricular filling pressure in an apparently healthy Korean population. Cardiovasc Ultrasound. 2013 Jan 9;11 (1):2.
  14. Albu A, Fodor D, Bondor C, Poantă L. Arterial stiffness, carotid atherosclerosis and left ventricular diastolic dysfunction in postmenopausal women. Eur J Intern Med. 2013 Apr;24 (3):250–4.
  15. Lian YK, Li HW, Wu YQ et al. The relationship between left ventricular diastolic function and arterial stiffness in diabetic coronary heart disease. Zhonghua Nei Ke Za Zhi. 2011 Aug;50 (8):676–9.
  16. Kim MN, Park SM, Shim WJ et al. The relationship between aortic stiffness and left ventricular dyssynchrony in hypertensive patients with preserved left ventricular systolic function. Clin Exp Hypertens. 2012;34 (6):410–6.
  17. Hsu PC, Tsai WC, Lin TH et al. Association of arterial stiffness and electrocardiography-determined left ventricular hypertrophy with left ventricular diastolic dysfunction. PLoS One. 2012;7 (11):e49100.
  18. Su HM, Lin TH, Hsu PC et al. Association of brachial-ankle pulse wave velocity, ankle-brachial index and ratio of brachial pre-ejection period to ejection time with left ventricular hypertrophy. Am J Med Sci. 2014 Apr;347 (4):289–94.
  19. Mizuguchi Y, Oishi Y, Tanaka H et al. Arterial stiffness is associated with left ventricular diastolic function in patients with cardiovascular risk factors: early detection with the use of cardio-ankle vascular index and ultrasonic strain imaging. J Card Fail. 2007 Nov;13 (9):744–51.
  20. Wang CP, Hung WC, Yu TH et al. Brachial-ankle pulse wave velo­city as an early indicator of left ventricular diastolic function among hypertensive subjects. Clin Exp Hypertens. 2009 Feb;31 (1):31–43.
  21. Chow B, Rabkin SW. Brachial-ankle pulse wave velocity is the only index of arterial stiffness that correlates with a mitral valve indices of diastolic dysfunction, but no index correlates with left atrial size. Cardiol Res Pract. 2013;2013:986847.
  22. Сумин А. Н., Галимзянов Д. М., Сергеева Т. Ю., Барбараш О. Л. Динамика показателей диастолической функции правого желудочков у больных острым коронарным синдромом после проведения чрескатетерного коронарного вмешательства. Журнал Сердечная Недостаточность. 2012;13 (6):334–41.
  23. El Aouar LM, Meyerfreud D, Magalhães P et al. Relationship between left atrial volume and diastolic dysfunction in 500 Brazilian patients. Arq Bras Cardiol. 2013 Jul;101 (1):52–8.
  24. Hermeling E, Vermeersch SJ, Rietzschel ER et al. The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals. J Hypertens. 2012 Feb;30 (2):396–402.
  25. Choi TY, Ahmadi N, Sourayanezhad S et al. Relation of vascular stiffness with epicardial and pericardial adipose tissues, and coronary atherosclerosis. Atherosclerosis. 2013 Jul;229 (1):118–23.
  26. Сумин А. Н., Карпович А. В., Безденежных А. В., Барбараш О. Л. Оценка сердечно-лодыжечного сосудистого индекса у больных ишемической болезнью сердца: влияние периферического атеросклероза. Кардиоваскулярная терапия и профилактика. 2013;12 (5):34–9.
  27. Барбараш О. Л., Кашталап В. В. Выявление латентного некоронарного атеросклероза у пациентов с острым коронарным синдромом. Есть ли смысл? Комплексные проблемы сердечно-сосудистых заболеваний. 2012;1:12–6.
  28. Hsu PC, Lin TH, Lee CS et al. Mismatch between arterial stiffness increase and left ventricular diastolic dysfunction. Heart Vessels. 2010 Nov;25 (6):485–92.
Sumin A. N., Osokina A. V., Shcheglova A. V. et al. EchoCG data in ihd patients with different cardio-ankle vascular indexes. Russian Heart Journal. 2015;14 (3):123–130

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