Javanmardi Elmira, Okazaki Ross A, Arash Niusha Manoochehri, Minetti Erika T, Weisbrod Robert M, Rizvi Syed Husain Mustafa, Li Zhuoheng, Akubo Chelsea, Hamburg Naomi M
Evans Department of Medicine, Section of Vascular Biology, and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA.
Am J Hypertens. 2025 Jun 24. doi: 10.1093/ajh/hpaf107.
Arterial stiffness and endothelial dysfunction are two important features of cardiovascular injury. Arterial stiffness can be measured by Pulse Wave Velocity (PWV) and endothelial dysfunction can be assessed with reactive hyperemia measured by Flow Mediated Dilation (FMD). Cardio-Ankle Vascular Index (CAVI) is a recently developed method for measuring arterial stiffness. Studies assessing CAVI's association with established tests of arterial stiffness and endothelial function are limited.
In a cross-sectional study of adults (ages 18-80) with a range of cardiovascular disease risk burden, we measured CAVI by VaSera, tonometry measures of arterial stiffness [carotid-radial PWV (CRPWV), carotid-femoral PWV (CFPWV)], and ultrasound based brachial artery measures of vasodilator function.
We enrolled 100 participants with acceptable quality from 93 subjects for primary analysis. The mean value of CAVI measure was 7.7±1.2. There was a significant association between CAVI and CFPWV (r=0.609, P<0.001), which remained significant after adjusting for systolic blood pressure while the association of CAVI with CRPWV was more modest. Higher Framingham Risk Score, older age, history of hypertension and diabetes were significantly associated with higher CAVI and CFPWV. There was not any association between CAVI and FMD. Higher CAVI was associated with lower reactive hyperemia, an indicator of vasodilator function in the microvasculature (r= -0.365, P<0.001).
Our findings suggest that CAVI relates to both central and peripheral artery stiffness though is not identical to tonometry measures. CAVI associates with microvascular but not conduit artery vasodilator function consistent with the interrelation of large artery stiffness with small vessel dysfunction.
动脉僵硬度和内皮功能障碍是心血管损伤的两个重要特征。动脉僵硬度可通过脉搏波速度（PWV）来测量，内皮功能障碍可通过血流介导的血管舒张（FMD）测量的反应性充血来评估。心踝血管指数（CAVI）是最近开发的一种测量动脉僵硬度的方法。评估CAVI与已确立的动脉僵硬度和内皮功能测试之间关联的研究有限。
在一项针对具有一系列心血管疾病风险负担的成年人（年龄18 - 80岁）的横断面研究中，我们通过VaSera测量CAVI、采用动脉僵硬度的眼压测量法[颈动脉 - 桡动脉PWV（CRPWV）、颈动脉 - 股动脉PWV（CFPWV）]以及基于超声的肱动脉血管舒张功能测量法。
我们从93名受试者中纳入了100名质量可接受的参与者进行初步分析。CAVI测量的平均值为7.7±1.2。CAVI与CFPWV之间存在显著关联（r = 0.609，P < 0.001），在调整收缩压后该关联仍然显著，而CAVI与CRPWV的关联则较为适度。较高的弗雷明汉风险评分、年龄较大、高血压和糖尿病病史与较高的CAVI和CFPWV显著相关。CAVI与FMD之间没有任何关联。较高的CAVI与较低的反应性充血相关，反应性充血是微血管系统中血管舒张功能的一个指标（r = -0.365，P < 0.001）。
我们的研究结果表明，CAVI与中心和外周动脉僵硬度均相关，但与眼压测量法不同。CAVI与微血管舒张功能相关，但与导管动脉舒张功能无关，这与大动脉僵硬度与小血管功能障碍的相互关系一致。
