Background: The cardio-ankle vascular index (CAVI) has recently been used as a new measure of arterial stiffness. Although associations have been widely reported between the CAVI score and atherosclerotic risk factors (ARFs), such correlations have been investigated in only a few longitudinal studies.
Objectives: To clarify the relationship between age-related change in CAVI scores with those in ARFs over a 3-year period.
Methods: A total of 76 men and 41 women were included in the study. The ARFs comprised age, BMI score, weight, abdominal circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), number of ARFs (RF score), metabolic score, total cholesterol (T-C), triglycerides (TG), high-density-lipoprotein cholesterol (HDL-C), low-density-lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), HbA1c, and smoking score. The patients were divided into 3 CAVI index groups based on the CAVI score: a low vascular age group (LVA; below the mean － SD); an equivalent VA group (EVA; within the mean ± SD); and a high VA group (HVA; above the mean ＋ SD). Differences in baseline ARFs among these 3 CAVI index groups were compared. Next changes in the CAVI index at 3 years later was used to classify the patients into 3 CAVI index change (ΔCAVI index) groups: a good group (Group 1: LVA maintained or CAVI index improved); an average group (Group 2: EVA maintained); and a poor group (Group 3: HVA maintained or CAVI index worsened). Changes in the ARFs (ΔARF) between at baseline and 3 years later were then compared among the 3 ΔCAVI index groups.
Comparison of ARFs at baseline among CAVI index groups
In men, the LVA group showed a lower age and RF score, and a higher BMI score and T-C; the HVA group showed a larger abdominal circumference, SBP, DBP, and metabolic score. In women, the LVA group showed a lower TG and higher smoking score.
Comparison of ARFs among ΔCAVI index groups
In men, Group 1 showed a higher SBP and only small increases in SBP and HbA1c. Group 3 showed a high BMI score, weight, abdominal circumference, and large increase in weight and DBP. In women, no significant difference was observed between Group 1 and Group 3.
Conclusion: In men, obesity, BP, and ARF were the determining factors for the CAVI index, and these factors were associated with its improvement or worsening. In women, TG and the smoking score were the determining factors for the CAVI index, but no factor was associated with its improvement or worsening. The single factor most strongly associated with the CAVI index was SBP in men and TG in women.
In the present study, we evaluated exercise tolerance using treadmill and arm ergometry or leg crank ergometry in patients with respiratory diseases who were or were not able to walk during their clinical course. We assessed which method made it better to provide the appropriate prescription of rehabilitation to optimize exercise intensity in their clinical recovery course. Between April 2020 and August 2021, we performed treadmill exercise tests in 59 patients with respiratory diseases, in 31 of whom (age 77.1 ± 10.0 yrs; male 24, female 7), oxygen intake (⩒o2) and anaerobic threshold (AT) were measured using an exhaled gas analyzer and compared between data using a treadmill and arm ergometry or leg crank test. ⩒o2 peak based on treadmill (9.4 ±2.9 kg/min) was significantly higher than that according to arm ergometry (6.7 ± 1.4 kg/min) (P ＝ 0.02). Although AT measured using treadmill (8.6 ± 2.0 kg/min) was higher than that measured using arm ergometry (6.4 ± 1.0 kg/min), the difference was not significant (P ＝ 0.14). ⩒o2 peak measured according to leg crank ergometry (8.3 ± 1.3 kg/min) was higher than that measured based on arm ergometry (6.7 ± 1.4 kg/min), but there was no significant difference (P ＝ 0.41). In conclusion, selecting the exercise test method according to the patient's condition could make it helpful to prescribe rehabilitation intensity.