Shirai Kohji, Saiki Atsuhito, Nagayama Daiji, Tatsuno Ichiro, Shimizu Kazuhiro, Takahashi Mao
Department of Vascular Function, Chiba, Japan ; Seijinkai Mihama Hospital, Chiba, Japan.
Diabetes Endocrine and Metabolism Center, Chiba, Japan.
Pulse (Basel). 2015 Sep;3(2):118-33. doi: 10.1159/000431235. Epub 2015 Jun 20.
Arteriosclerosis is a major contributor to cardiovascular diseases. One of the difficulties in controlling those diseases is the lack of a suitable indicator of arteriosclerosis or arterial injury in routine clinical practice. Arterial stiffness was supposed to be one of the monitoring indexes of arteriosclerosis. Cardio-ankle vascular index (CAVI) is reflecting the stiffness of the arterial tree from the origin of the aorta to the ankle, and one of the features of CAVI is independency from blood pressure at a measuring time. When doxazosin, an α1-adrenergic blocker, was administered, CAVI decreased, indicating that arterial stiffness is composed of both organic stiffness and functional stiffness, which reflects the contraction of arterial smooth muscle. CAVI shows a high value with aging and in many arteriosclerotic diseases, and is also high in persons possessing main coronary risk factors such as diabetes mellitus, metabolic syndrome, hypertension and smoking. Furthermore, when the most of those risk factors were controlled by proper methods, CAVI improved. Furthermore, the co-relationship between CAVI and heart function was demonstrated during treatment of heart failure. This paper reviews the principle and rationale of CAVI, and discusses the meaning of monitoring CAVI in following up so-called lifestyle-related diseases and cardiac dysfunction in routine clinical practice.
动脉硬化是心血管疾病的主要促成因素。控制这些疾病的困难之一在于，在常规临床实践中缺乏合适的动脉硬化或动脉损伤指标。动脉僵硬度被认为是动脉硬化的监测指标之一。心-踝血管指数（CAVI）反映了从主动脉起源到脚踝的动脉树僵硬度，CAVI的特点之一是在测量时不受血压影响。当给予α1肾上腺素能阻滞剂多沙唑嗪时，CAVI降低，这表明动脉僵硬度由器质性僵硬度和功能性僵硬度组成，后者反映了动脉平滑肌的收缩。CAVI在衰老以及许多动脉硬化疾病中呈现高值，在患有糖尿病、代谢综合征、高血压和吸烟等主要冠心病危险因素的人群中也较高。此外，当通过适当方法控制大多数这些危险因素时，CAVI有所改善。此外，在心力衰竭治疗期间，CAVI与心功能之间的相关性得到了证实。本文综述了CAVI的原理和基本原理，并讨论了在常规临床实践中监测CAVI对随访所谓生活方式相关疾病和心脏功能障碍的意义。
