Correlation of arterial stiffness parameters with indicators of carotid atherosclerosis in patients with Metabolic Syndrome

Saule Urazalina 1 * , Aisulu Mussagaliyeva 1, Guzеl Ussayeva 1, Amina Rakhisheva 1
More Detail
1 Department of cardiology, Scientific-Research Institute of Cardiology and Internal diseases, Almaty city, Republic of Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 3, Issue 57, pp. 11-18. https://doi.org/10.23950/1812-2892-JCMK-00759
OPEN ACCESS 2041 Views 1593 Downloads
Download Full Text (PDF)

ABSTRACT

Background: Many studies have shown that metabolic syndrome is accompanied by an increase in arterial stiffness. In connection therewith, early detection of an increase in arterial stiffness in patients with metabolic syndrome can help to prevent cardiovascular complications.
Aim: To determine the relationship between arterial stiffness parameters such as cfPWV and CAVI with carotid atherosclerosis indicators (intima-media thickness, carotid plaque presence) in patients with metabolic syndrome.
Material and methods: The study included 100 patients at the age of 40-70 years: 45 men and 55 women (56.54±8.98 years). Subjects were divided into 2 groups: 1st - 42 patients with metabolic syndrome; 2nd - 58 patients without metabolic syndrome. The arterial stiffness parameters such as CAVI and cfPWV were calculated. In the analysis we used threshold values recommended by manufacturers and European expert consensus document on arterial stiffness: for CAVI – <8, for cfPWV – ≤10 m/c). Duplex scanning carotid arteries was performed to evaluate the “intima-media thickness” and carotid plaque presence.
Results: In the group with metabolic syndrome the CAVI is significantly associated with the indicators of carotid atherosclerosis: intima-media thickness (OR=4.94 95%; CI: 1.49-3.80; p=0.047), carotid plaque presence (OR=3.06; 95% CI: 1.42-2.28; p=0.065). But statistically significant associations of cfPWV with indicators of carotid atherosclerosis were not obtained (p>0.05). In the group without metabolic syndrome none of the arterial stiffness parameters (CAVI, cfPWV) statistically significantly correlated with any of the carotid atherosclerosis indicators (p>0.05).
Conclusion: The CAVI parameter, in contrast to the cfPWV, statistically significantly correlated with indicators of carotid atherosclerosis in patients with metabolic syndrome. In this connection, this parameter can be used to identify signs of not only increased arterial stiffness but also to determine subclinical signs of carotid atherosclerosis in patients with metabolic syndrome.
Keywords: metabolic syndrome, arterial stiffness, CAVI, carotid atherosclerosis

CITATION

Urazalina S, Mussagaliyeva A, Ussayeva G, Rakhisheva A. Correlation of arterial stiffness parameters with indicators of carotid atherosclerosis in patients with Metabolic Syndrome. Journal of Clinical Medicine of Kazakhstan. 2020;3(57):11-8. https://doi.org/10.23950/1812-2892-JCMK-00759

REFERENCES

  • Laurent S, Cockcroft J, van Bortel L, et al. European network for non-invasive investigation of large arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006; 27:2588-605. https://doi.org/10.1093/eurheartj/ehl254
  • Van Popele NE, Grobbee DE, Bots ML, et al. Association between arterial stiffness and atherosclerosis. The Rotterdam study. Stroke. 2011; 32:454-60. https://doi.org/10.1161/01.str.32.2.454
  • Cameron JD, Asmar R, Struijker-Boudier H, et al. Current and future initiatives for vascular health management in clinical practice. Vasc Health Risk Manag. 2013; 9:255-64. https://doi.org/10.2147/VHRM.S42947.
  • Vachopoulos C, Aznaouridis K, Stefanidis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness. A systematic review and meta-analysis. J Am Coll Cardiol. 2010; 55(13):1318-27. https://doi.org/10.1016/j.jacc.2009.10.061.
  • WilliaMetS B, Mancia G, Spiering W, et al. 2018 ESH/ESC Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33):3021-3104. https://doi.org/10.1093/eurheartj/ehy686.
  • Alberti GJ, Eckel RH, Grundy SM, et al. Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circul. 2009; 120:1640-45. https://doi.org/10.1161/CIRCULATIONAHA.109.192644.
  • Nakanishi N, Suzuki K, Tatara K. Clustered Features of the Metabolic Syndrome and the Risk for Increased Aortic Pulse Wave Velocity in Middle-aged Japanese Men. Angiology. 2003; 54(5):551-9. https://doi.org/10.3904/kjim.2003.21.2.109ю
  • Liu H, Zhang X, Feng X, et al. Effects of metabolic syndrome on cardio-ankle vascular index in middle-aged and elderly Chinese. Metab Syndr Relat Disord. 2011; 9(2):105-10. https://doi.org/10.1155/2011/328585.
  • Laucevičius A, Ryliškyt L, Balsyt J, et al. Association of cardio-ankle vascular index with cardiovascular risk factors and cardiovascular events in metabolic syndrome patients. Medicina. 2015; 51(3):152-58. https://doi.org/10.1016/j.medici.2015.05.001.
  • Satoh N, Shimatsu A, Kato Y, et al. Evaluation of the cardio-ankle vascular index, a new indicator of arterial stiffness independent of blood pressure, in obesity and metabolic syndrome. Hypertens Res. 2008; 31:1921–30. https://doi.org/10.1291/hypres.31.1921.
  • Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso C. Association of metabolic syndrome and its components with arterial stiffness in Caucasian subjects of the MARK study: a cross-sectional trial. Cardiovasc Diabetol. 2016; 15:148. https://doi.org/10.1186/s12933-016-0465-7.
  • Townsend RR, Wilkinson IB, Schiffrin EL, et al.; American Heart Association Council on Hypertension. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness. A Scientific Statement from the American Heart Association. J Hypertension. 2015; 66(3):698-722. https://doi.org/10.1161/HYP.0000000000000033.
  • Shirai K, Hiruta N, Song M, et al. Cardio-Ankle Vascular Index (CAVI) as a Novel Indicator of Arterial Stiffness: Theory, Evidence and Perspectives. J Atheroscler Thromb. 2011; 18(11):924-38. https://doi.org/10.5551/jat.7716.
  • Kotani K, Remaley AT. Cardio-Ankle Vascular Index (CAVI) and its Potential Clinical Implications for Cardiovascular Disease. Cardiol Pharmacol. 2013; 2:108. https://doi.org/10.4172/2329-6607.1000108.
  • Shirai K, Utino J, Saiki A, et al. Evaluation of Blood Pressure Control using A New Arterial Stiffness parameter, Cardio-Ankle Vascular Index (CAVI). Curr Hypertens Rev. 2013; 9(1):66-7. https://doi.org/10.2174/1573402111309010010.
  • Takaki A, Ogawa H, Wakeyama T, et al. Cardio-ankle vascular index is superior to brachial-ankle pulse wave velocity as an index of arterial stiffness. Hypertens Res. 2008; 31(7):1347-55. https://doi.org/10.1291/hypres.31.1347.
  • Kohgi S, Jungi U, Otsuka K, Takata M. A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI). J of Atherosclerosis and Thrombosis. 2003; 13:101-7. https://doi.org/10.5551/jat.13.101
  • Kubozono T, Miyata M, Ueyama K. et al. Clinical significance, reproducibility of new arterial distensibility index. Circul. 2007; 71:89-94. https://doi.org/10.1253/circj.71.89.
  • Nakamura K, Tomaru T, Yamamura Sh, et al. Cardio-ankle vascular index is a candidate predictor of coronary atherosclerosis. Circul. 2008; 72:598-604. https://doi.org/10.1253/circj.72.598.
  • Horinaka S, Yabe A, Yaqi H, et al. Comparison of atherosclerotic indicators between cardio-ankle vascular index and brachial ankle pulse wave velocity. Angiology. 2009; 60:468-76. https://doi.org/10.1177/0003319708325443.
  • Kadota K, Takamura N, Aoyagi K, et al. Availability of cardio-ankle vascular index as a screening tool for atherosclerosis. Circulation. 2008; 72:304-8. https://doi.org/10.1253/circj.72.304.
  • Shirai K, Utino J, Otsuka K, Tokata M. A novel blood pressure-independent arterial wall stiffness parameter: cardio-ankle vascular index (CAVI). J Atheroscler Thromb. 2006; 13:101-7. https://doi.org/10.5551/jat.13.101.
  • Perk J, De Backer G, Gohlke H, et al. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). Eur Heart J. 2012; 33(13):1635-1701. https://doi.org/10.1093/eurheartj/ehs092.
  • Thomas GB, Halperin LJ, Abbara S, et al. 2011ASA/ACCF/AHA/AANN/AANS/ACR/ASNR Guideline on the management of patients with extracranial carotid and vertebral artery disease. JАCC. 2011; 57(8):1002–44. https://doi.org/10.1136/jnis.2011.004762. 
  • Amato M, Veglio F, Ulf de Faire, et al. Carotid plaque-thickness and common carotid IMT show additive value in cardiovascular risk prediction and reclassification. Atherosclerosis. 2017; 263:412–19. https://doi.org/10.1016/j.atherosclerosis.2017.05.023.
  • Greenland Р, Alpert JS, Beller G A, et al. 2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults. J Am Coll Cardiol. 2010; 56(25):2182–99. https://doi.org/10.1016/j.jacc.2010.09.001.
  • Inaba Y, Chen J, Bergmann SR. Carotid plaque, compared with intima-media thickness, more accurately predicts coronary artery disease events: a meta-analysis. Atheroscl. 2012; 220(1):122–33. https://doi.org/10.1016/j.atherosclerosis.2011.06.044
  • Helfand M, Buckley DI, Freeman M, et al. Emerging Risk Factors for Coronary Heart Disease: A Summary of Systematic Reviews Conducted for the U.S. Preventive Services Task Force. Annals Internal Medicine. 2009; 151(7):496-507. https://doi.org/10.7326/0003-4819-151-7-200910060-00010.
  • Hyun J Y, Kim KH, Park H, et al. Carotid plaque rather than intima-media thickness as a predictor of recurrent vascular events in patients with acute ischemic stroke. Cardiovasc Ultrasound. 2017; 15:19-19. https://doi.org/10.1186/s12947-017-0110-y.
  • Riley WA, Evans GW, Sharrett AR, et al. Variation of common carotid artery elasticity with intima-medial thickness: the ARIC Study: Atherosclerosis Risk in Communities. Ultrasound Med Biol. 1997; 23:157-64. https://doi.org/10.1016/s0301-5629(96)00211-6.
  • Anonymous. Third report of the National Cholesterol Education Program (NCEP): Expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III): final report. Circulation. 2002; 106:3143–3421.
  • Van Bortel LM, Laurent S, Boutouyrie P, et al. Artery Society; European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012; 30:445–448. https://doi.org/10.1097/HJH.0b013e32834fa8b0.
  • Stein J H, Korcarz CE, Hurst RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American society of Echocardiography Carotid Intima-Media thickness Task Force: Endorsed by the Society for vascular medicine. J Am Soc Echocardiog. 2008; 21(2):93–111. https://doi.org/10.1016/j.echo.2007.11.011.
  • Rogoza AN. Basic noninvasive methods quantifying vascular wall stiffness. Doctor ru. 2010; 3(54):23-9.
  • Rotar OP, Ivanenko VV, Konradi AO, Shlyakhto EV. Vascular stiffness in healthy subjects with cardiovascular risk factors. Arterial Hyperten. 2010; 16 (2):145-49.
  • Koivistoinen T, Hutri-Kahonen N, Juonala M, et al. Metabolic syndrome in childhood and increased arterial stiffness in adulthood: the Cardiovascular Risk in Young Finns Study. Ann Med. 2011; 43:312-19. https://doi.org/10.3109/07853890.2010.549145
  • Izuhara M, Shioji K, Shin K, et al. Relationship of Cardio-Ankle Vascular Index (CAVI) to Carotid and Coronary Arteriosclerosis. Circ J. 2008; 72(11):1762-67. https://doi.org/10.1253/circj.CJ-08-0152.
  • Okura T, Watanabe S, Kurata M, et al. Relationship between cardio-ankle vascular index (CAVI) and carotid atherosclerosis in patients with essential hypertension. Hypertens Res. 2007; 30:335-40. https://doi.org/10.1291/hypres.30.335.
  • Suzuki J, Kurosu T, Kon T, Tomaru T. Impact of Cardiovascular Risk Factors on Progression of Arteriosclerosis in Younger Patients: Evaluation by Carotid Duplex Ultrasonography and Cardio-Ankle Vascular Index (CAVI). J Atherosclerosis and Thrombosis. 2014; 21(6):554-62. https://doi.org/10.5551/jat.20438.