Sex differences in associations of cardio-ankle vascular index with left ventricular function and geometry

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Abstract

The cardio-ankle vascular index (CAVI) is a measure of global arterial stiffness. We hypothesized that CAVI is associated with left ventricular (LV) function and geometry in individuals without structural heart disease. We measured CAVI in 600 participants (mean age 60.3±14.6 years, 54% men) without history of atherosclerotic cardiovascular disease who were referred for transthoracic echocardiography. Linear regression analysis was used to assess the association of CAVI with LV function (peak mitral annular systolic s’ and early diastolic velocity e’) and structure (LV mass index (LVMI) and relative wall thickness (RWT)). Older age, male sex, lower body mass index, history of hypertension, diabetes and chronic kidney disease were each associated with a higher CAVI (adjusted R2 = 0.56, all p < 0.01). A higher CAVI was associated with lower s’ and e’, and greater RWT, independent of age, sex, systolic BP and other conventional cardiovascular risk factors (all p < 0.05); a borderline association of higher CAVI with greater LVMI (p = 0.05) was present. Associations with e’, s’ and RWT were similar in women and men but the association with LVMI was stronger in women than in men (p for interaction = 0.02, multivariable-adjusted β = 6.92, p < 0.001 in women; p > 0.1 in men). In conclusion, a higher CAVI, a measure of global arterial stiffness, is associated with worse LV systolic function, worse diastolic relaxation, and greater LV RWT in both men and women, and with LVMI in women.

Original languageEnglish (US)
Pages (from-to)465-472
Number of pages8
JournalVascular Medicine (United Kingdom)
Volume22
Issue number6
DOIs
StatePublished - Dec 1 2017

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Left Ventricular Function
Ankle
Sex Characteristics
Blood Vessels
Vascular Stiffness
Chronic Renal Insufficiency
Echocardiography
Linear Models
Heart Diseases
Body Mass Index
Cardiovascular Diseases
Regression Analysis
Hypertension

Keywords

  • arterial stiffness
  • cardio-ankle vascular index
  • left ventricular mass index
  • relative wall thickness
  • sex differences

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Sex differences in associations of cardio-ankle vascular index with left ventricular function and geometry",
abstract = "The cardio-ankle vascular index (CAVI) is a measure of global arterial stiffness. We hypothesized that CAVI is associated with left ventricular (LV) function and geometry in individuals without structural heart disease. We measured CAVI in 600 participants (mean age 60.3±14.6 years, 54{\%} men) without history of atherosclerotic cardiovascular disease who were referred for transthoracic echocardiography. Linear regression analysis was used to assess the association of CAVI with LV function (peak mitral annular systolic s’ and early diastolic velocity e’) and structure (LV mass index (LVMI) and relative wall thickness (RWT)). Older age, male sex, lower body mass index, history of hypertension, diabetes and chronic kidney disease were each associated with a higher CAVI (adjusted R2 = 0.56, all p < 0.01). A higher CAVI was associated with lower s’ and e’, and greater RWT, independent of age, sex, systolic BP and other conventional cardiovascular risk factors (all p < 0.05); a borderline association of higher CAVI with greater LVMI (p = 0.05) was present. Associations with e’, s’ and RWT were similar in women and men but the association with LVMI was stronger in women than in men (p for interaction = 0.02, multivariable-adjusted β = 6.92, p < 0.001 in women; p > 0.1 in men). In conclusion, a higher CAVI, a measure of global arterial stiffness, is associated with worse LV systolic function, worse diastolic relaxation, and greater LV RWT in both men and women, and with LVMI in women.",
keywords = "arterial stiffness, cardio-ankle vascular index, left ventricular mass index, relative wall thickness, sex differences",
author = "Zi Ye and Patricia Pellikka and Kullo, {Iftikhar Jan}",
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AU - Pellikka, Patricia

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N2 - The cardio-ankle vascular index (CAVI) is a measure of global arterial stiffness. We hypothesized that CAVI is associated with left ventricular (LV) function and geometry in individuals without structural heart disease. We measured CAVI in 600 participants (mean age 60.3±14.6 years, 54% men) without history of atherosclerotic cardiovascular disease who were referred for transthoracic echocardiography. Linear regression analysis was used to assess the association of CAVI with LV function (peak mitral annular systolic s’ and early diastolic velocity e’) and structure (LV mass index (LVMI) and relative wall thickness (RWT)). Older age, male sex, lower body mass index, history of hypertension, diabetes and chronic kidney disease were each associated with a higher CAVI (adjusted R2 = 0.56, all p < 0.01). A higher CAVI was associated with lower s’ and e’, and greater RWT, independent of age, sex, systolic BP and other conventional cardiovascular risk factors (all p < 0.05); a borderline association of higher CAVI with greater LVMI (p = 0.05) was present. Associations with e’, s’ and RWT were similar in women and men but the association with LVMI was stronger in women than in men (p for interaction = 0.02, multivariable-adjusted β = 6.92, p < 0.001 in women; p > 0.1 in men). In conclusion, a higher CAVI, a measure of global arterial stiffness, is associated with worse LV systolic function, worse diastolic relaxation, and greater LV RWT in both men and women, and with LVMI in women.

AB - The cardio-ankle vascular index (CAVI) is a measure of global arterial stiffness. We hypothesized that CAVI is associated with left ventricular (LV) function and geometry in individuals without structural heart disease. We measured CAVI in 600 participants (mean age 60.3±14.6 years, 54% men) without history of atherosclerotic cardiovascular disease who were referred for transthoracic echocardiography. Linear regression analysis was used to assess the association of CAVI with LV function (peak mitral annular systolic s’ and early diastolic velocity e’) and structure (LV mass index (LVMI) and relative wall thickness (RWT)). Older age, male sex, lower body mass index, history of hypertension, diabetes and chronic kidney disease were each associated with a higher CAVI (adjusted R2 = 0.56, all p < 0.01). A higher CAVI was associated with lower s’ and e’, and greater RWT, independent of age, sex, systolic BP and other conventional cardiovascular risk factors (all p < 0.05); a borderline association of higher CAVI with greater LVMI (p = 0.05) was present. Associations with e’, s’ and RWT were similar in women and men but the association with LVMI was stronger in women than in men (p for interaction = 0.02, multivariable-adjusted β = 6.92, p < 0.001 in women; p > 0.1 in men). In conclusion, a higher CAVI, a measure of global arterial stiffness, is associated with worse LV systolic function, worse diastolic relaxation, and greater LV RWT in both men and women, and with LVMI in women.

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