Сердечно-лодыжечный сосудистый индекс в диагностике, определении степени тяжести и риска поражения магистральных сосудов у пациентов с сердечно-сосудистыми заболеваниями и сахарным диабетом 2-го типа
Сердечно-лодыжечный сосудистый индекс в диагностике, определении степени тяжести и риска поражения магистральных сосудов у пациентов с сердечно-сосудистыми заболеваниями и сахарным диабетом 2-го типа
Вернер В.А., Мельник М.В., Князева С.А. Сердечно-лодыжечный сосудистый индекс в диагностике, определении степени тяжести и риска поражения магистральных сосудов у пациентов с сердечно-сосудистыми заболеваниями и сахарным диабетом 2-го типа. Терапевтический архив. 2021; 93 (1): 87–93.
DOI:10.26442/00403660.2021.01.200599
DOI:10.26442/00403660.2021.01.200599
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Аннотация
Исследование жесткости сосудистой стенки, являющейся важным прогностическим фактором развития сердечно-сосудистых осложнений у пациентов с атеросклерозом, гипертонической болезнью и сахарным диабетом, проводится по различным параметрам, среди которых особый интерес вызывает сердечно-лодыжечный сосудистый индекс – СЛСИ (cardio-ankle vascular index, СAVI). Цель данного обзора – анализ данных зарубежных и российских исследований, касающихся использования СЛСИ при оценке жесткости магистральных артерий. СЛСИ измеряется неинвазивным методом при помощи портативных устройств, которые можно использовать как в амбулаторных отделениях у пациентов, проходящих профилактические осмотры, так и в условиях стационара у пациентов, находящихся на лечении. Для измерения СЛСИ от персонала не требуется специальных навыков, процедура занимает несколько минут. Значения СЛСИ не зависят от колебаний артериального давления, он более точно отражает степень структурных поражений сосудов по сравнению с плече-лодыжечной скоростью распространения пульсовой волны. Его показания коррелируют со многими маркерами сердечно-сосудистых заболеваний, в том числе с наличием (и степенью) атеросклеротических поражений сосудов, диастолической дисфункцией левого желудочка, наличием стенокардии. СЛСИ может использоваться в клинике для ранней диагностики поражений органов-мишеней и сосудов у пациентов с атеросклерозом, артериальной гипертонией (АГ) и сахарным диабетом 2-го типа. Внедрение СЛСИ в стандартный протокол обследования пациентов группы риска позволит осуществить профилактику сердечно-сосудистых осложнений, снизить смертность и увеличить ожидаемую продолжительность жизни таких пациентов.
Ключевые слова: сердечно-лодыжечный сосудистый индекс, сосудистая стенка, жесткость сосудов, пульсовая волна, атеросклероз, сахарный диабет 2-го типа, артериальное давление
Keywords: cardio-ankle vascular index, blood vessels, vascular wall, arterial stiffness, pulse wave, atherosclerosis, type 2 diabetes, blood pressure
Ключевые слова: сердечно-лодыжечный сосудистый индекс, сосудистая стенка, жесткость сосудов, пульсовая волна, атеросклероз, сахарный диабет 2-го типа, артериальное давление
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Keywords: cardio-ankle vascular index, blood vessels, vascular wall, arterial stiffness, pulse wave, atherosclerosis, type 2 diabetes, blood pressure
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4. Laurent S, Boutouyrie P. Recent advances in arterial stiffness and wave reflection in human hypertension. Hypertension. 2007;49:1202-6. doi: 10.1161/hypertensionaha.106.076166
5. Aoun S, Blacher J, Safar ME, et al. Diabetes mellitus and renal failure: effects on large artery stiffness. J Hum Hypertens. 2001;15(10):693-700. doi: 10.1038/sj.jhh.1001253
6. Collaboration of authors. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J. 2010;31(19):2338-50. doi: 10.1093/eurheartj/ehq165
7. Yun J, Kim JY, Kim OY, et al. Associations of plasma homocysteine level with brachialankle pulse wave velocity, LDL atherogenicity, andinflammation profile in healthy men. Nutr Metab Cardiovasc Dis. 2011;21(2):136-43. doi: 10.1016/j.numecd.2009.08.003
8. Gomez-Marcos MA, Recio-Rodríguez JI, Patino-Alonso MC, et al. Relationships between high-sensitive C-reactive protein and markers of arterial stiffness in hypertensive patients. Differences by sex. BMC Cardiovasc Disord. 2012;12:37. doi: 10.1186/1471-2261-12-37
9. Mattace-Raso FU, van der Cammen TJ, Hofman A, et al. Arterial Stiffness and Risk of Coronary Heart Disease and Stroke: The Rotterdam Study. Circulation. 2006;113:657-63. doi: 10.1161/CIRCULATIONAHA.
105.555235
10. Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, et al. 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(1):148. doi: 10.1186/s12933-016-0465-7
11. Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension. 2009;54(6):1328-36. doi: 10.1161/HYPERTENSIONAHA.109.137653
12. Van Popele NM, Grobbee DE, Bots ML, et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke. 2001;32:454-60. doi: 10.1161/01.STR.32.2.454
13. O'Rourke MF, Hashimoto J. Mechanical factors in arterial aging: a clinical perspective. J Am Coll Cardiol. 2007;50(1):1-13. doi: 10.1016/j.jacc.2006.12.050
14. Corman B, Duriez M, Poitevin P, et al. Aminoguanidine prevents age-related arterial stiffening and cardiac hypertrophy. Proceedings of the National Academy of Sciences. 1998;95(3):1301-6. doi: 10.1073/pnas.95.3.1301
15. Brands PJ, Willigers JM, Ledoux LAF, et al. A noninvasive method to estimate pulse wave velocity in arteries locally by means of ultrasound. Ultrasound Med Biol. 1998;24(9):1325-35. doi: 10.1016/s0301-5629(98)00126-4
16. Yambe T, Yoshizawa M, Saijo Y, et al. Brachio-ankle pulse wave velocity and cardio-ankle vascular index (CAVI). Biomed Pharmacother. 2004;58:S95-8. doi: 10.1016/s0753-3322(04)80015-5
17. Niki K, Sugawara M, Chang D, et al. Noninvasive measurement of common carotid artery effect with echo phase tracking system. Journal of Japanese College of Angiology. 1982;22:241-8. doi: 10.1007/s003800200037
18. Shirai K, Utino J, Otsuka K, Takata M. A Novel Blood Pressure-independent Arterial Wall Stiffness Parameter; Cardio-Ankle Vascular Index (CAVI). J Atheroscler Thromb. 2006;13(2):101-7. doi: 10.5551/jat.13.101
19. Kim B, Takada K. Influence of blood pressure on cardio-ankle vascular index (CAVI) examined based on percentage change during general anesthesia. Hypertens Res. 2011;34(6):779-83. doi: 10.1038/hr.2011.31
20. Shirai K. Analysis of vascular function using the cardio-ankle vascular index (CAVI). Hypertens Res. 2011;34(6):684-85. doi: 10.1038/hr.2011.40
21. Shirai K, Song M, et al. Contradictory effects of β1- and α1-aderenergic receptor blockers on cardio-ankle vascular stiffness index (CAVI) – CAVI independent of blood pressure. J Atheroscler Thromb. 2011;18(1). doi: 10.5551/jat.3582
22. Takaki A, 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. doi: 10.1291/hypres.31.1347
23. Horinaka S, Yabe A, et al. Comparison of Atherosclerotic Indicators Between Cardio Ankle Vascular Index and Brachial Ankle Pulse Wave Velocity. Angiology. 2008;60(4):468-76. doi: 10.1177/0003319708325443
24. Izuhara M, Shioji K, et al. Relationship of Cardio-Ankle Vascular Index (CAVI) to Carotid and Coronary Arteriosclerosis. Circ J. 2008;72(11):1762-7. doi: 10.1253/circj.cj-08-0152
25. Nagayama D, Imamura H, Sato Y, et al. Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects: a cross-sectional study. Vasc Health Risk Manag. 2016;13:1-9. doi: 10.2147/VHRM.S119646
26. Fukuda-Denshi Company L, Tokyo, Japan. Available at: http://www.fukuda.co.jp. Accessed: 16.04.2013.
27. Namekata T, Suzuki K, Ishizuka N, Shirai K. Establishing baseline criteria of cardio-ankle vascular index as a new indicator of arteriosclerosis: a cross-sectional study. BMC Cardiovasc Disord. 2011;11(1):51. doi: 10.1186/1471-2261-11-51
28. Сумин А.Н., Щеглова А.В., и др. Взаимосвязь пограничных значений сердечно-лодыжечного сосудистого индекса с клинико-инструментальными показателями у больных ИБС. Сиб. научный мед. журн. 2014 [Sumin AN, Shcheglova AV, et al. Correlation of borderline values of cardio-vascular ankle indexes with clinical and instrumental parameters in patients with coronary heart disease. The Siberian Scientific Medical Journal. 2014 (in Russ.)]. doi: 10.29001/2073-8552-2017-32-1-67-70
29. Sun C-K. Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness. Integr Blood Press Control. 2013;27. doi: 10.2147/ibpc.s34423
30. Laucevičius A, Ryliškytė L, Balsytė J, et al. Association of cardio-ankle vascular index with cardiovascular risk factors and cardiovascular events in metabolic syndrome patients. Medicina. 2015;51(3):152-8. doi: 10.1016/j.medici.2015.05.001
31. Miyoshi T, Doi M, Hirohata S, et al. Cardio-Ankle Vascular Index is Independently Associated with the Severity of Coronary Atherosclerosis and Left Ventricular Function in Patients with Ischemic Heart Disease. J Atheroscler Thromb. 2010;17(3):249-58. doi: 10.5551/jat.1636
32. Nakamura K, Tomaru T, Yamamura S, et al. Cardio-Ankle Vascular Index is a Candidate Predictor of Coronary Atherosclerosis. Circ J. 2008;72(4):598-604. doi: 10.1253/circj.72.598
33. Mineoka Y, Fukui M, Tanaka M, et al. Relationship between cardio-ankle vascular index (CAVI) and coronary artery calcification (CAC) in patients with type 2 diabetes mellitus. Heart Vessels. 2011;27(2):160-5. doi: 10.1007/s00380-011-0138-0
34. Сумин А.Н., Щеглова А.В., Федорова Н.В., Артамонова Г.В. Значения сердечно-лодыжечного сосудистого индекса у здоровых лиц разного возраста по данным исследования ЭССЕ-РФ в Кемеровской области. Кардиоваскулярная терапия и профилактика. 2015;14(5):67-72 [Sumin AN, Shcheglova AV, Fedorova NV, Artamonova GV. Values of cardial-ankle vascular index in healthy people of different age by the data of ESSE-RF study in Kemerovskaya region. Cardiovascular Therapy and Prevention. 2015;14(5):67-72 (In Russ.)]. doi: 10.15829/1728-8800-2015-5-67-72
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49. Sato Y, Nagayama D, Ban N, et al. Cardio Ankle Vascular Index (CAVI) is an independent predictor of cardiovascular events. Eur Heart J. 2013;34(suppl. 1):P1586. doi: 10.1093/eurheartj/eht308.p1586
50. Ibata J, Sasaki H, Hanabusa T, et al. Increased arterial stiffness is closely associated with hyperglycemia and improved by glycemic control in diabetic patients. J Diabetes Investig. 2012;4(1):82-7. doi: 10.1111/j.2040-1124.2012.00229.x
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2. Mitchell GF. Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage. J Appl Physiol. 2008;105:1652-60. doi: 10.1152/japplphysiol.90549.2008
3. Taylor M.G. Wave travel in arteries and the design of the cardiovascular system. In: Pulsatile Blood Flow. Ed. EO Attinger. NewYork: McGrawHill, 1964; p. 343-7. doi: 10.1016/j.artres.2009.02.002
4. Laurent S, Boutouyrie P. Recent advances in arterial stiffness and wave reflection in human hypertension. Hypertension. 2007;49:1202-6. doi: 10.1161/hypertensionaha.106.076166
5. Aoun S, Blacher J, Safar ME, et al. Diabetes mellitus and renal failure: effects on large artery stiffness. J Hum Hypertens. 2001;15(10):693-700. doi: 10.1038/sj.jhh.1001253
6. Collaboration of authors. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J. 2010;31(19):2338-50. doi: 10.1093/eurheartj/ehq165
7. Yun J, Kim JY, Kim OY, et al. Associations of plasma homocysteine level with brachialankle pulse wave velocity, LDL atherogenicity, andinflammation profile in healthy men. Nutr Metab Cardiovasc Dis. 2011;21(2):136-43. doi: 10.1016/j.numecd.2009.08.003
8. Gomez-Marcos MA, Recio-Rodríguez JI, Patino-Alonso MC, et al. Relationships between high-sensitive C-reactive protein and markers of arterial stiffness in hypertensive patients. Differences by sex. BMC Cardiovasc Disord. 2012;12:37. doi: 10.1186/1471-2261-12-37
9. Mattace-Raso FU, van der Cammen TJ, Hofman A, et al. Arterial Stiffness and Risk of Coronary Heart Disease and Stroke: The Rotterdam Study. Circulation. 2006;113:657-63. doi: 10.1161/CIRCULATIONAHA.
105.555235
10. Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, et al. 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(1):148. doi: 10.1186/s12933-016-0465-7
11. Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension. 2009;54(6):1328-36. doi: 10.1161/HYPERTENSIONAHA.109.137653
12. Van Popele NM, Grobbee DE, Bots ML, et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke. 2001;32:454-60. doi: 10.1161/01.STR.32.2.454
13. O'Rourke MF, Hashimoto J. Mechanical factors in arterial aging: a clinical perspective. J Am Coll Cardiol. 2007;50(1):1-13. doi: 10.1016/j.jacc.2006.12.050
14. Corman B, Duriez M, Poitevin P, et al. Aminoguanidine prevents age-related arterial stiffening and cardiac hypertrophy. Proceedings of the National Academy of Sciences. 1998;95(3):1301-6. doi: 10.1073/pnas.95.3.1301
15. Brands PJ, Willigers JM, Ledoux LAF, et al. A noninvasive method to estimate pulse wave velocity in arteries locally by means of ultrasound. Ultrasound Med Biol. 1998;24(9):1325-35. doi: 10.1016/s0301-5629(98)00126-4
16. Yambe T, Yoshizawa M, Saijo Y, et al. Brachio-ankle pulse wave velocity and cardio-ankle vascular index (CAVI). Biomed Pharmacother. 2004;58:S95-8. doi: 10.1016/s0753-3322(04)80015-5
17. Niki K, Sugawara M, Chang D, et al. Noninvasive measurement of common carotid artery effect with echo phase tracking system. Journal of Japanese College of Angiology. 1982;22:241-8. doi: 10.1007/s003800200037
18. Shirai K, Utino J, Otsuka K, Takata M. A Novel Blood Pressure-independent Arterial Wall Stiffness Parameter; Cardio-Ankle Vascular Index (CAVI). J Atheroscler Thromb. 2006;13(2):101-7. doi: 10.5551/jat.13.101
19. Kim B, Takada K. Influence of blood pressure on cardio-ankle vascular index (CAVI) examined based on percentage change during general anesthesia. Hypertens Res. 2011;34(6):779-83. doi: 10.1038/hr.2011.31
20. Shirai K. Analysis of vascular function using the cardio-ankle vascular index (CAVI). Hypertens Res. 2011;34(6):684-85. doi: 10.1038/hr.2011.40
21. Shirai K, Song M, et al. Contradictory effects of β1- and α1-aderenergic receptor blockers on cardio-ankle vascular stiffness index (CAVI) – CAVI independent of blood pressure. J Atheroscler Thromb. 2011;18(1). doi: 10.5551/jat.3582
22. Takaki A, 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. doi: 10.1291/hypres.31.1347
23. Horinaka S, Yabe A, et al. Comparison of Atherosclerotic Indicators Between Cardio Ankle Vascular Index and Brachial Ankle Pulse Wave Velocity. Angiology. 2008;60(4):468-76. doi: 10.1177/0003319708325443
24. Izuhara M, Shioji K, et al. Relationship of Cardio-Ankle Vascular Index (CAVI) to Carotid and Coronary Arteriosclerosis. Circ J. 2008;72(11):1762-7. doi: 10.1253/circj.cj-08-0152
25. Nagayama D, Imamura H, Sato Y, et al. Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects: a cross-sectional study. Vasc Health Risk Manag. 2016;13:1-9. doi: 10.2147/VHRM.S119646
26. Fukuda-Denshi Company L, Tokyo, Japan. Available at: http://www.fukuda.co.jp. Accessed: 16.04.2013.
27. Namekata T, Suzuki K, Ishizuka N, Shirai K. Establishing baseline criteria of cardio-ankle vascular index as a new indicator of arteriosclerosis: a cross-sectional study. BMC Cardiovasc Disord. 2011;11(1):51. doi: 10.1186/1471-2261-11-51
28. Сумин А.Н., Щеглова А.В., и др. Взаимосвязь пограничных значений сердечно-лодыжечного сосудистого индекса с клинико-инструментальными показателями у больных ИБС. Сиб. научный мед. журн. 2014 [Sumin AN, Shcheglova AV, et al. Correlation of borderline values of cardio-vascular ankle indexes with clinical and instrumental parameters in patients with coronary heart disease. The Siberian Scientific Medical Journal. 2014 (in Russ.)]. doi: 10.29001/2073-8552-2017-32-1-67-70
29. Sun C-K. Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness. Integr Blood Press Control. 2013;27. doi: 10.2147/ibpc.s34423
30. Laucevičius A, Ryliškytė L, Balsytė J, et al. Association of cardio-ankle vascular index with cardiovascular risk factors and cardiovascular events in metabolic syndrome patients. Medicina. 2015;51(3):152-8. doi: 10.1016/j.medici.2015.05.001
31. Miyoshi T, Doi M, Hirohata S, et al. Cardio-Ankle Vascular Index is Independently Associated with the Severity of Coronary Atherosclerosis and Left Ventricular Function in Patients with Ischemic Heart Disease. J Atheroscler Thromb. 2010;17(3):249-58. doi: 10.5551/jat.1636
32. Nakamura K, Tomaru T, Yamamura S, et al. Cardio-Ankle Vascular Index is a Candidate Predictor of Coronary Atherosclerosis. Circ J. 2008;72(4):598-604. doi: 10.1253/circj.72.598
33. Mineoka Y, Fukui M, Tanaka M, et al. Relationship between cardio-ankle vascular index (CAVI) and coronary artery calcification (CAC) in patients with type 2 diabetes mellitus. Heart Vessels. 2011;27(2):160-5. doi: 10.1007/s00380-011-0138-0
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49. Sato Y, Nagayama D, Ban N, et al. Cardio Ankle Vascular Index (CAVI) is an independent predictor of cardiovascular events. Eur Heart J. 2013;34(suppl. 1):P1586. doi: 10.1093/eurheartj/eht308.p1586
50. Ibata J, Sasaki H, Hanabusa T, et al. Increased arterial stiffness is closely associated with hyperglycemia and improved by glycemic control in diabetic patients. J Diabetes Investig. 2012;4(1):82-7. doi: 10.1111/j.2040-1124.2012.00229.x
51. Gómez-Marcos M, Recio-Rodríguez J, Patino-Alonso M, et al. Cardio-ankle vascular index is associated with cardiovascular target organ damage and vascular structure and function in patients with diabetes or metabolic syndrome, LOD-DIABETES study: a case series report. Cardiovasc Diabetol. 2015;14(1):7. doi: 10.1186/s12933-014-0167-y
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Авторы
В.А. Вернер, М.В. Мельник, С.А. Князева
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России
(Сеченовский Университет), Москва, Россия
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России
(Сеченовский Университет), Москва, Россия
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Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.