Clinical significance of the parameter CAVI (Cardio-Ankle Vascular Index) in prevention, diagnosis and therapy
Abstract
Loss of elasticity of the arterial wall accompanied by its stiffening has been identified as an independent prognostic factor in patients with cardiovascular dis-eases. The standard non-invasive investigation of arterial stiffness is the measurement of pulse-wave velocity (PWV), but its accuracy is affected by changes in blood pressure (BP) at the time of measurement.
Because an exponential relationship exists between intravascular pressure and diameter of the artery, an arterial wall stiffness parameter β can be defined using the natural logarithm of the ratio of systolic and diastolic blood pressure and the elasticity of the arterial wall. Parameter β is the basis for the calculation of CAVI (Cardio-Ankle Vascular Index), which is independent of changes in BP.
This is a big advantage of CAVI, which has been the subject of intense clinical research in the past decade, focusing on the evaluation of arterial stiffness in patients with existing cardiovascular disease and also in patients at increased risk, such as those with hypertension, diabetes or obesity. The primary objective of the dia-gnostic use of CAVI is the assessment of arterial stiffness and early detection of atherosclerosis.
CAVI can be successfully used for monitoring the possible progression of the disease and effectiveness of treatment. Nevertheless, it is recommended that the CAVI measurement is evaluated with some caution because its elevated values reflect vascular stiffness induced by pathological mechanisms in the arterial wall, as well as the increased arterial tension resulting from smooth muscle contractions.