Zhang Chengmin, Ohira Masahiro, Iizuka Takuo, Mikamo Hiroshi, Nakagami Takahiro, Suzuki Masayo, Hirano Keiichi, Takahashi Mao, Shimizu Kazuhiro, Sugiyama Yuko, Yamaguchi Takashi, Kawana Hidetoshi, Endo Kei, Saiki Atsuhito, Oyama Tomokazu, Kurosu Takumi, Tomaru Takanobu, Wang Hongyu, Noike Hirofumi, Shirai Kohji
Department of Cardiology, Zichuan District Hospital, Zibo, China.
Int Heart J. 2013;54(4):216-21. doi: 10.1536/ihj.54.216.
The cardio-ankle vascular index (CAVI) has been proposed as a new noninvasive marker of arterial stiffness independent of blood pressure. Arterial stiffness is closely related to afterload, and elevated afterload aggravates heart failure. We hypothesized that CAVI is a potential marker of afterload in patients with heart failure. Thirty patients who were admitted because of acute heart failure were identified retrospectively from a review of clinical records. Plasma brain natriuretic peptide (BNP) levels, CAVI, cardiothoracic ratio (CTR), and echocardiographic parameters obtained during acute and chronic phases of heart failure were analyzed. Left ventricular ejection fraction (LVEF) increased significantly and CTR, BNP and CAVI decreased significantly after treatment of heart failure. A significant negative correlation was observed between the change in CAVI and change in LVEF in all subjects (r = -0.3272, P < 0.05). To examine the relationship between CAVI and LVEF, we divided the patients into two subgroups (∆CAVI < -0.5; CAVI decrease group, ∆CAVI ≥ -0.5; CAVI non-decrease group). CAVI was significantly improved after heart failure treatment only in the CAVI decrease group. LVEF decreased significantly in both groups, but the P value was smaller in the CAVI decrease group than in the CAVI non-decrease group. The change in LVEF correlated significantly with the change in CAVI in the CAVI decrease group (r = -0.4201, P < 0.05), whereas no significant correlation was found in the CAVI non-decrease group. CAVI correlates inversely with LVEF after heart failure treatment. Our results suggest that CAVI might partially reflect the afterload in patients with heart failure.
心踝血管指数（CAVI）已被提出作为一种独立于血压的动脉僵硬度新的无创标志物。动脉僵硬度与后负荷密切相关，后负荷升高会加重心力衰竭。我们假设CAVI是心力衰竭患者后负荷的潜在标志物。通过回顾临床记录，对30例因急性心力衰竭入院的患者进行了回顾性研究。分析了心力衰竭急性和慢性阶段获得的血浆脑钠肽（BNP）水平、CAVI、心胸比率（CTR）和超声心动图参数。心力衰竭治疗后，左心室射血分数（LVEF）显著增加，CTR、BNP和CAVI显著降低。在所有受试者中，CAVI的变化与LVEF的变化之间存在显著负相关（r = -0.3272，P < 0.05）。为了研究CAVI与LVEF之间的关系，我们将患者分为两个亚组（∆CAVI < -0.5；CAVI降低组，∆CAVI ≥ -0.5；CAVI未降低组）。仅在CAVI降低组中，心力衰竭治疗后CAVI显著改善。两组的LVEF均显著降低，但CAVI降低组的P值小于CAVI未降低组。在CAVI降低组中，LVEF的变化与CAVI的变化显著相关（r = -0.4201，P < 0.05），而在CAVI未降低组中未发现显著相关性。心力衰竭治疗后，CAVI与LVEF呈负相关。我们的结果表明，CAVI可能部分反映心力衰竭患者的后负荷。
