Shimizu Kazuhiro, Yamamoto Tomoyuki, Shirai Kohji
Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan.
Department of Vascular Function, Toho University Sakura Medical Center, Chiba, Japan; Biological Information Analysis Section, Fukuda Denshi Co., Ltd., Tokyo, Japan.
Int Med Case Rep J. 2016 Aug 9;9:231-5. doi: 10.2147/IMCRJ.S113377. eCollection 2016.
The cardio-ankle vascular index (CAVI) is an indicator of arterial stiffness from the heart to the ankles. The CAVI increases as arteriosclerosis progresses, but it can be decreased by appropriate treatment. There are several risk factors for coronary artery disease, however, the degree of stress caused by each separate risk factor to arteries cannot be assessed. CAVI increases with age and according to the severity of atherosclerosis. We found that CAVI also changes in response to the control of risk factors, which may be associated with the functional stiffness of arteries. CAVI can be a useful indicator of risk control for coronary artery disease. We followed a patient aged 71 years who had diabetes mellitus and obstructive sleep apnea (OSA) by measuring CAVI for 8 years from age 63. He underwent coronary artery bypass grafting due to angina pectoris when he was 63 years old. Before coronary artery bypass grafting, CAVI was 11.8 on the right and 11.5 on the left. Three years later he was found to have OSA and received treatment with continuous positive airway pressure. There was a marked improvement in CAVI after continuous positive airway pressure (age 68; right 10.4, left 10.2). However, following a gradual increase in body weight and worsening of diabetes mellitus, CAVI showed an increasing trend. CAVI decreased with biguanides treatment, but increased again with an increase in body weight. In conclusion, CAVI responded to the patient's conditions including obesity, diabetes mellitus, and OSA. CAVI is not only a marker of arterial stiffness, but can also be a useful indicator of physiological status; it may be effective in total risk control for coronary artery disease.
心踝血管指数（CAVI）是反映从心脏到脚踝动脉僵硬度的一个指标。随着动脉硬化的进展，CAVI会升高，但通过适当治疗可使其降低。冠状动脉疾病存在多种危险因素，然而，无法评估每个单独危险因素对动脉造成的压力程度。CAVI随年龄增长以及动脉粥样硬化的严重程度而升高。我们发现，CAVI也会因危险因素的控制而发生变化，这可能与动脉的功能性僵硬度有关。CAVI可能是冠状动脉疾病风险控制的一个有用指标。我们对一名71岁患有糖尿病和阻塞性睡眠呼吸暂停（OSA）的患者进行了跟踪，从其63岁起测量CAVI长达8年。他63岁时因心绞痛接受了冠状动脉搭桥手术。冠状动脉搭桥手术前，右侧CAVI为11.8，左侧为11.5。三年后，他被诊断出患有OSA，并接受了持续气道正压通气治疗。持续气道正压通气治疗后，CAVI有显著改善（68岁时；右侧10.4，左侧10.2）。然而，随着体重逐渐增加以及糖尿病病情恶化，CAVI呈上升趋势。使用双胍类药物治疗时CAVI下降，但随着体重增加又再次上升。总之，CAVI会因患者的肥胖、糖尿病和OSA等情况而发生变化。CAVI不仅是动脉僵硬度的一个标志物，还可能是生理状态有用的指标；它在冠状动脉疾病的总体风险控制中可能有效。
