Stroke and Cardio-ankle Vascular Stiffness Index

• Published in: Journal of stroke and cerebrovascular diseases 2013-02, Vol.22 (2), p.171-175
• Main Authors: Suzuki, Jun, Sakakibara, Ryuji, MD, PhD, Tomaru, Takanobu, MD, PhD, Tateno, Fuyuki, MD, Kishi, Masahiko, MD, PhD, Ogawa, Emina, MD, Kurosu, Takumi, Shirai, Kohji, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Ankle - blood supply; Arterial stiffness; atherosclerosis; Brain Ischemia - diagnostic imaging; Brain Ischemia - physiopathology; cardio-ankle vascular stiffness index; Cardiovascular; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - physiopathology; cerebrovascular disease; Diagnostic Techniques, Cardiovascular - standards; Female; Humans; Intracranial Arteriosclerosis - diagnostic imaging; Intracranial Arteriosclerosis - physiopathology; Ischemic Attack, Transient - diagnostic imaging; Ischemic Attack, Transient - physiopathology; Linear Models; Male; Middle Aged; Models, Biological; Neurology; Reference Values; stroke; Stroke - diagnostic imaging; Stroke - physiopathology; Ultrasonography; Vascular Stiffness - physiology
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2011.07.010

Background We investigated the relationship between stroke and cardio-ankle vascular stiffness index (CAVI), a novel noninvasive measure of vascular stiffness. Methods Eighty-five patients with cerebrovascular disease who underwent CAVI were enrolled in the current study. They were 63 men and 22 women with a mean age of 70.0 ± 10.8 years. They were divided into 4 groups according to neurologic abnormalities and magnetic resonance imaging (MRI) findings: 12 with transient ischemic attack (TIA), 26 with white matter ischemic lesions (WMLs), 17 with large artery atherosclerosis, and 30 with small vessel occlusion. Eight hundred fifty-four healthy patients (487 men and 367 women; mean age 65.1 ± 9.4 years) served as controls. The results were stratified by gender and age and statistically analyzed using the Fisher, Bonferroni–Dunn, and Scheffe tests. Results The average of CAVI was as follows: control males 60 to 69 years of age, 9.05 ± 0.82 (as a representative value); TIA, 9.3 ± 1.5; WML, 10.3 ± 1.3; large artery atherosclerosis, 10.2 ± 1.2; and small vessel occlusion, 10.0 ± 1.6, respectively. The difference in CAVI between each group and age- and gender-matched controls was 0.492 for TIA (no statistical significance); WML, 0.733 ( P < .001, and P = .002 Scheffe); large artery atherosclerosis, 0.838 ( P < .001, and P = .005 Scheffe); and small vessel occlusion, 1.034 ( P < .001), respectively. Linear regression analysis of CAVI and plaque score revealed a significant relationship in patients with ischemic cerebrovascular disease ( P < .05). Conclusions Compared with healthy control subjects, CAVI is statistically greater in patients with ischemic cerebrovascular diseases, particularly with WML, large artery atherosclerosis, and small vessel occlusion, but not in patients with TIA. CAVI had a clear relationship with carotid ultrasound plaque score. It appears that CAVI is a simple and noninvasive test for indicating atherosclerosis in patients with stroke.