Aykan Ahmet Çağrı, Menteşe Seda, Doğan Emre, Çavuşoğlu İsmail Gökhan, Aykan Duygun Altıntaş, Kalaycıoğlu Ezgi, Gökdeniz Tayyar, Menteşe Ümit
Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey
Department of Emergency Medicine, Numune Training and Research Hospital, Trabzon, Turkey.
Phlebology. 2016 Jun;31(5):349-55. doi: 10.1177/0268355515591394. Epub 2015 Jun 10.
OBJECTIVES: Arterial stiffness is associated with major adverse cardiovascular events. Chronic venous insufficiency (CVI) is severe form of chronic venous disease (CVD). The aim of this study is to investigate arterial stiffness by cardio-ankle vascular index (CAVI) in patients with CVI. METHODS: This observational and cross-sectional study involved 87 subjects with CVI and 86 healthy subjects. All subjects underwent ultrasonography examination. CAVI was measured by VaSera-1000 CAVI instrument. RESULTS: High density lipoprotein cholesterol (HDL) was significantly lower in patients with CVI than controls (46.83 ± 9.25 mg/dl vs 51.33 ± 11.13 mg/dl, p = 0.004). Body mass index (BMI) was significantly higher in CVI patients than controls (28.53 ± 4.10 kg/m(2) vs 26.37 ± 5.16 kg/m(2), p = 0.003). Ankle brachial index (ABI) was significantly lower in patients with CVI compared to controls (1.08 ± 0.08 vs 1.14 ± 0.11, p < 0.001). CAVI was significantly higher in patients with CVI than controls (7.94 ± 1.37 vs 6.73 ± 1.16, p < 0.001). Mean arterial pressure (MAP) was significantly higher in patients with CVI than control group (105.41 ± 10.77 mmHg vs 99.70 ± 11.17 mmHg, p = 0.001). CAVI (p < 0.001, Odds ratio (OR) = 2.033, 95% Confidence interval (CI) = 1.493-2.768), ABI (p = 0.003, OR = 0.003, 95% CI = 0.001-0.137), female sex (p < 0.001, OR = 3.949, 95% CI = 1.613-9.663), and HDL (p < 0.001, OR = 0.923, 95% CI = 0.883-0.964) were the independent predictors of CVI. A CAVI value > 7.9 had a sensitivity 64.4% and a specificity of 94.7% for predicting the presence of CVI in ROC analysis (area under curve = 0.791, 95% CI = 0.723-0.849, p < 0.001). CONCLUSION: CAVI is independently increased in CVI patients. Therefore CVI may be accepted a form of vascular sclerosis and vascular system should be evaluated in continuum not isolated.
目的：动脉僵硬度与主要不良心血管事件相关。慢性静脉功能不全（CVI）是慢性静脉疾病（CVD）的严重形式。本研究旨在通过心踝血管指数（CAVI）对CVI患者的动脉僵硬度进行调查。 方法：这项观察性横断面研究纳入了87例CVI患者和86例健康受试者。所有受试者均接受了超声检查。使用VaSera - 1000 CAVI仪器测量CAVI。 结果：CVI患者的高密度脂蛋白胆固醇（HDL）显著低于对照组（46.83±9.25mg/dl对51.33±11.13mg/dl，p = 0.004）。CVI患者的体重指数（BMI）显著高于对照组（28.53±4.10kg/m²对26.37±5.16kg/m²，p = 0.003）。CVI患者的踝臂指数（ABI）显著低于对照组（1.08±0.08对1.14±0.11，p < 0.001）。CVI患者的CAVI显著高于对照组（7.94±1.37对6.73±1.16，p < 0.001）。CVI患者的平均动脉压（MAP）显著高于对照组（105.41±10.77mmHg对99.70±11.17mmHg，p = 0.001）。CAVI（p < 0.001，比值比（OR）= 2.033，95%置信区间（CI）= 1.493 - 2.768）、ABI（p = 0.003，OR = 0.003，95% CI = 0.001 - 0.137）、女性性别（p < 0.001，OR = 3.949，95% CI = 1.613 - 9.663）和HDL（p < 0.001，OR = 0.923，95% CI = 0.883 - 0.964）是CVI的独立预测因素。在ROC分析中，CAVI值>7.9对预测CVI存在的敏感性为64.4%，特异性为94.7%（曲线下面积 = 0.791，95% CI = 0.723 - 0.849，p < 0.001）。 结论：CVI患者的CAVI独立升高。因此，CVI可能被视为一种血管硬化形式，血管系统应作为一个连续整体而非孤立地进行评估。
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