AUTHOR=Watanabe Koichiro , Yoshihisa Akiomi , Sato Yu , Hotsuki Yu , Anzai Fumiya , Ichijo Yasuhiro , Kimishima Yusuke , Yokokawa Tetsuro , Misaka Tomofumi , Sato Takamasa , Kaneshiro Takashi , Oikawa Masayoshi , Kobayashi Atsushi , Takeishi Yasuchika 

TITLE=Cardio-Ankle Vascular Index Reflects Impaired Exercise Capacity and Predicts Adverse Prognosis in Patients With Heart Failure

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.631807

DOI=10.3389/fcvm.2021.631807

ISSN=2297-055X

ABSTRACT=<p><bold>Aims:</bold> We aimed to assess the associations of CAVI with exercise capacity in heart failure (HF) patients. In addition, we further examined their prognosis.</p><p><bold>Methods:</bold> We collected the clinical data of 223 patients who had been hospitalized for decompensated HF and had undergone both CAVI and cardiopulmonary exercise testing.</p><p><bold>Results:</bold> For the prediction of an impaired peak oxygen uptake (VO<sub>2</sub>) of &lt; 14 mL/kg/min, receiver-operating characteristic curve demonstrated that the cutoff value of CAVI was 8.9. In the multivariate logistic regression analysis for predicting impaired peak VO<sub>2</sub>, high CAVI was found to be an independent factor (odds ratio 2.343, <italic>P</italic> = 0.045). We divided these patients based on CAVI: the low-CAVI group (CAVI &lt; 8.9, <italic>n</italic> = 145) and the high-CAVI group (CAVI ≥ 8.9, <italic>n</italic> = 78). Patient characteristics and post-discharge cardiac events were compared between the two groups. The high-CAVI group was older (69.0 vs. 58.0 years old, <italic>P</italic> &lt; 0.001) and had lower body mass index (23.0 vs. 24.1 kg/m<sup>2</sup>, <italic>P</italic> = 0.013). During the post-discharge follow-up period of median 1,623 days, 58 cardiac events occurred. The Kaplan–Meier analysis demonstrated that the cardiac event rate was higher in the high-CAVI group than in the low-CAVI group (log–rank <italic>P</italic> = 0.004). The multivariate Cox proportional hazard analysis revealed that high CAVI was an independent predictor of cardiac events (hazard ratio 1.845, <italic>P</italic> = 0.035).</p><p><bold>Conclusion:</bold> High CAVI is independently associated with impaired exercise capacity and a high cardiac event rate in HF patients.</p>