Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Novo Nordisk A/S, Medical & Science, Copenhagen, Denmark.
Vasc Health Risk Manag. 2023 May 24;19:325-328. doi: 10.2147/VHRM.S401221. eCollection 2023.
Cardio-ankle vascular index (CAV) is a measure of systemic arterial stiffness and has been shown to increase after aortic valve surgery. However, change in CAVI-derived pulse wave morphology has not previously been addressed.
A 72-year-old female was transferred to a large center for heart valve interventions for evaluation of her aortic stenosis. Few co-morbidities were detected on medical history, other than previous radiation treatment for breast cancer, and no signs of other concomitant cardiovascular disease. The patient was accepted for surgical aortic valve replacement due to severe aortic valve stenosis and arterial stiffness was assessed with CAVI, as part of an ongoing clinical study. The pre-operative CAVI was 4.7 which after surgery increased almost 100% to 9.35. In tandem, the slope of systolic upstroke pulse morphology captured from brachial cuffs was changed from a prolonged flattened pattern to a steeper.
After aortic valve replacement surgery due to aortic valve stenosis, in addition to increased CAVI-derived measures of arterial stiffness, the slope of the CAVI-derived upstroke pulse wave morphology changes to a steeper slope. This finding could have implications in the future of aortic valve stenosis screening and utilization of CAVI.
心血管踝指数（CAVI）是一种评估系统性动脉僵硬程度的指标，已被证明在主动脉瓣手术后会增加。然而，CAVI 衍生的脉搏波形态的变化尚未得到解决。
一名 72 岁女性因主动脉瓣狭窄被转至一家大型心脏瓣膜介入中心进行评估。除了之前因乳腺癌接受过放射治疗外，病史中几乎没有其他合并症，也没有其他伴随心血管疾病的迹象。由于严重的主动脉瓣狭窄，患者接受了主动脉瓣置换手术，并且作为正在进行的临床研究的一部分，使用 CAVI 评估了动脉僵硬。术前 CAVI 为 4.7，术后几乎增加了 100%，达到 9.35。与此同时，从肱动脉袖带捕获的收缩期上升脉搏形态的斜率从延长的平坦模式变为更陡峭。
由于主动脉瓣狭窄行主动脉瓣置换手术后，除了 CAVI 衍生的动脉僵硬程度指标增加外，CAVI 衍生的上升脉搏波形态的斜率也会变得更陡峭。这一发现可能对未来的主动脉瓣狭窄筛查和 CAVI 的应用具有重要意义。
