Cardio-ankle vascular index is associated with cardiovascular target organ damage and vascular structure and function in patients with diabetes or metabolic syndrome, LOD-DIABETES study: a case series reportReportar como inadecuado




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Cardiovascular Diabetology

, 14:7

First Online: 16 January 2015Received: 25 October 2014Accepted: 28 December 2014

Abstract

BackgroundThe cardio ankle vascular index CAVI is a new index of the overall stiffness of the artery from the origin of the aorta to the ankle.
This index can estimate the risk of atherosclerosis.
We aimed to find the relationship between CAVI and target organ damage TOD, vascular structure and function, and cardiovascular risk factors in Caucasian patients with type 2 diabetes mellitus or metabolic syndrome.

MethodsWe included 110 subjects from the LOD-Diabetes study, whose mean age was 61 ± 11 years, and 37.3% were women.
Measurements of CAVI, brachial ankle pulse wave velocity ba-PWV, and ankle brachial index ABI were taken using the VaSera device.
Cardiovascular risk factors, renal function by creatinine, glomerular filtration rate, and albumin creatinine index were also obtained, as well as cardiac TOD with ECG and vascular TOD and carotid intima media thickness IMT, carotid femoral PWV cf-PWV, and the central and peripheral augmentation index CAIx and PAIx.
The Framingham-D’Agostino scale was used to measure cardiovascular risk.

ResultsMean CAVI was 8.7 ± 1.3.
More than half 54% of the participants showed one or more TOD 10% cardiac, 13% renal; 48% vascular, and 13% had ba-PWV ≥ 17.5 m-s.
Patients with any TOD had the highest CAVI values: 1.15 CI 95% 0.70 to 1.61, p < 0.001 and 1.14 CI 95% 0.68 to 1.60, p < 0.001 when vascular TOD was presented, and 1.30 CI 95% 0.51 to 2.10, p = 0.002 for the cardiac TOD.
The CAVI values had a positive correlation with HbA1c and systolic and diastolic blood pressure, and a negative correlation with waist circumference and body mass index.
The positive correlations of CAVI with IMT β = 0.29; p < 0.01, cf-PWV β = 0.83; p < 0.01, ba-PWV β = 2.12; p < 0.01, CAIx β = 3.42; p < 0.01, and PAIx β = 5.05; p = 0.04 remained after adjustment for cardiovascular risk, body mass index, and antihypertensive, lipid-lowering, and antidiabetic drugs.

ConclusionsThe results of this study suggest that the CAVI is positively associated with IMT, cf-PWV, ba-PWV, CAIx, and PAIx, regardless of cardiovascular risk and the drug treatment used.
Patients with cardiovascular TOD have higher values of CAVI.

Trial registrationClinical Trials.gov Identifier: NCT01065155

KeywordsTarget organ damage Cardio ankle vascular index Vascular structure Vascular function Cardiovascular risk Diabetes mellitus type 2 Metabolic syndrome AbbreviationsABIAnkle-brachial index

AVArteriolar-venular

AVRArteriolar-venular ratio

ba-PWVBrachial ankle pulse wave velocity

BMIBody mass index

BPBlood pressure

CAVICardio ankle vascular index

CAIxCentral augmentation index

cf-PWVCarotid femoral pulse wave velocity

Cornell VDPCornell voltage-duration product

DBPDiastolic blood pressure

MDRD-IDMSModification of diet in renal disease-isotopic dilution mass spectrometry

GFRGlomerular filtration rate

ICCIntra-class correlation coefficient

IMTIntima-media thickness

LVHLeft ventricular hypertrophy

PAIxPeripheral augmentation index

PWVPulse wave velocity

TODTarget organ damage

SBPSystolic blood pressure

T2DMType 2 diabetes mellitus

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Autor: Manuel Ángel Gómez-Marcos - José Ignacio Recio-Rodríguez - María Carmen Patino-Alonso - Cristina Agudo-Conde - Leticia

Fuente: https://link.springer.com/article/10.1186/s12933-014-0167-y



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