10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED
Objectives: Arterial stiffness index β and cardio-ankle vascular index (CAVI) are widely accepted to quantify the blood pressure (BP)-independent, intrinsic exponent (β0) of the BP-diameter relationship. CAVI and β assume an exponential relationship between pressure (P) and diameter (d). We aim (1)...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2016-11-01
|
| Series: | Artery Research |
| Online Access: | https://www.atlantis-press.com/article/125930456/view |
| _version_ | 1811335846351077376 |
|---|---|
| author | Bart Spronck Alberto Avolio Isabella Tan Mark Butlin Koen Reesink Tammo Delhaas |
| author_facet | Bart Spronck Alberto Avolio Isabella Tan Mark Butlin Koen Reesink Tammo Delhaas |
| author_sort | Bart Spronck |
| collection | DOAJ |
| description | Objectives: Arterial stiffness index β and cardio-ankle vascular index (CAVI) are widely accepted to quantify the blood pressure (BP)-independent, intrinsic exponent (β0) of the BP-diameter relationship. CAVI and β assume an exponential relationship between pressure (P) and diameter (d). We aim (1) to demonstrate that, under this assumption, β and CAVI as currently implemented are inherently BP-dependent and (2) to provide corrected, BP-independent forms of CAVI and β.
Methods and results: In P=Pref*exp[β0(d/dref−1)], usually reference pressure (Pref) and reference diameter (dref) are substituted with diastolic BP and diameter to accommodate measurements. Consequently, the resulting exponent is not equal to the pressure-independent β0. CAVI does not only suffer from this reference pressure effect, but also from the approximation of dP/dd.
For example, assuming β0=7, an increase of systolic/diastolic BP from 110/70 to 170/120 mmHg increased β by 8.1% and CAVI by 14.3%. We derived corrected forms of β and of CAVI (CAVI0) that did not change with BP and represent the pressure-independent β0.
To substantiate the BP effect on CAVI in a typical follow-up study, we realistically simulated patients (n=161) before and following BP-lowering treatment (assuming no follow-up change in intrinsic β0 and therefore in actual P-d relationship). Lowering BP from 160±14/111±11 to 120±15/79±11 mmHg (p<0.001) resulted in a significant CAVI decrease (8.1±2.0 to 7.7±2.1, p=0.008) CAVI0 did not change (9.8±2.4 and 9.9±2.6, p=0.499).
Conclusions: β and CAVI as currently implemented are inherently BP-dependent, potentially leading to erroneous conclusions in arterial stiffness research. BP-independent forms were derived to overcome this problem. |
| first_indexed | 2024-04-13T17:30:54Z |
| format | Article |
| id | doaj.art-c00b791c002f4ac1a0820b79ac573831 |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-04-13T17:30:54Z |
| publishDate | 2016-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-c00b791c002f4ac1a0820b79ac5738312022-12-22T02:37:35ZengBMCArtery Research1876-44012016-11-011610.1016/j.artres.2016.10.08710.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTEDBart SpronckAlberto AvolioIsabella TanMark ButlinKoen ReesinkTammo DelhaasObjectives: Arterial stiffness index β and cardio-ankle vascular index (CAVI) are widely accepted to quantify the blood pressure (BP)-independent, intrinsic exponent (β0) of the BP-diameter relationship. CAVI and β assume an exponential relationship between pressure (P) and diameter (d). We aim (1) to demonstrate that, under this assumption, β and CAVI as currently implemented are inherently BP-dependent and (2) to provide corrected, BP-independent forms of CAVI and β. Methods and results: In P=Pref*exp[β0(d/dref−1)], usually reference pressure (Pref) and reference diameter (dref) are substituted with diastolic BP and diameter to accommodate measurements. Consequently, the resulting exponent is not equal to the pressure-independent β0. CAVI does not only suffer from this reference pressure effect, but also from the approximation of dP/dd. For example, assuming β0=7, an increase of systolic/diastolic BP from 110/70 to 170/120 mmHg increased β by 8.1% and CAVI by 14.3%. We derived corrected forms of β and of CAVI (CAVI0) that did not change with BP and represent the pressure-independent β0. To substantiate the BP effect on CAVI in a typical follow-up study, we realistically simulated patients (n=161) before and following BP-lowering treatment (assuming no follow-up change in intrinsic β0 and therefore in actual P-d relationship). Lowering BP from 160±14/111±11 to 120±15/79±11 mmHg (p<0.001) resulted in a significant CAVI decrease (8.1±2.0 to 7.7±2.1, p=0.008) CAVI0 did not change (9.8±2.4 and 9.9±2.6, p=0.499). Conclusions: β and CAVI as currently implemented are inherently BP-dependent, potentially leading to erroneous conclusions in arterial stiffness research. BP-independent forms were derived to overcome this problem.https://www.atlantis-press.com/article/125930456/view |
| spellingShingle | Bart Spronck Alberto Avolio Isabella Tan Mark Butlin Koen Reesink Tammo Delhaas 10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED Artery Research |
| title | 10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED |
| title_full | 10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED |
| title_fullStr | 10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED |
| title_full_unstemmed | 10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED |
| title_short | 10.9 ARTERIAL STIFFNESS INDEX BETA AND CARDIO-ANKLE VASCULAR INDEX INHERENTLY DEPEND ON BLOOD PRESSURE, BUT CAN BE READILY CORRECTED |
| title_sort | 10 9 arterial stiffness index beta and cardio ankle vascular index inherently depend on blood pressure but can be readily corrected |
| url | https://www.atlantis-press.com/article/125930456/view |
| work_keys_str_mv | AT bartspronck 109arterialstiffnessindexbetaandcardioanklevascularindexinherentlydependonbloodpressurebutcanbereadilycorrected AT albertoavolio 109arterialstiffnessindexbetaandcardioanklevascularindexinherentlydependonbloodpressurebutcanbereadilycorrected AT isabellatan 109arterialstiffnessindexbetaandcardioanklevascularindexinherentlydependonbloodpressurebutcanbereadilycorrected AT markbutlin 109arterialstiffnessindexbetaandcardioanklevascularindexinherentlydependonbloodpressurebutcanbereadilycorrected AT koenreesink 109arterialstiffnessindexbetaandcardioanklevascularindexinherentlydependonbloodpressurebutcanbereadilycorrected AT tammodelhaas 109arterialstiffnessindexbetaandcardioanklevascularindexinherentlydependonbloodpressurebutcanbereadilycorrected |