CAVI and START indices in arterial stiffness assessment in chronic obstructive pulmonary disease: comparative characterization and correlation with functional and anthropometric data

Background. The cardio-ankle vascular index (CAVI) index is commonly used as an indicator of arterial stiffness independent of blood pressure (BP) at the time of the measurement. Russian developers proposed the START (STiffness of ARTeries) arterial stiffness index that can be calculated online based on pulse wave velocity (PWV) and BP.
Objective. To analyze the relationship of START and CAVI indices with anthropometric data, BP and pulmonary function in patients with chronic obstructive pulmonary disease (COPD).
Design and methods. Seventy-two COPD patients underwent volume sphymography to determine CAVI, cardio-ankle PWV (haPWV) and BP, then cardio-ankle START index (haSTART) was calculated. Spirometry and bodyplethysmography were performed to assess pulmonary function disorders. Statistical data processing was performed by the means of partial and intraclass correlation analysis, regression models were constructed for both indices of arterial stiffness.
Results. Strong correlation was found between CAVI and haSTART indices (r = 0,97, p < 0,001). Intraclass correlation between haSTART and CAVI indices was 0,848 (95 % CI 0,756-0,905). Significant positive partial cor relation of CAVI and haSTART indices with age (r_p = 0,34, p = 0,005 and r_p = 0,32, p = 0,007, respectively) and with mean BP (BPmean) (r_p = 0,46, p < 0,001 and r_p = 0,48, p < 0,001, respectively) was observed. Both CAVI and haSTART were negatively correlated with body mass index (BMI) (r_p = –0,38, p = 0,001 and r_p = −0,31, p = 0,010, respectively). Statistically significant partial correlation was found between both arterial stiffness indices and pulmonary ventilation parameters. The strongest correlation was observed between both CAVI and haSTART indices and residual volume (r_p = 0,48, p < 0,001 and r_p = 0,49, p < 0,001, respectively). Based on the results of regression analysis, the following models were constructed: CAVI = 1,530 + 0,062 × AGE – 0,084 × BMI + 0,041 × BPmean + 0,009 × RV, F = 13,94, p < 0,001, R² = 0,45 and haSTART = –8,122 + 0,135 × AGE – 0,149 × BMI + 0,095 × BPmean + 0,021 × RV, F = 12,57, p < 0,001, R² = 0,43.
Conclusion. Both haSTART and CAVI indices can be used to assess arterial stiffness in patients with COPD. Both indices have similar correlation patterns with age, mean BP, BMI and with the parameters of pulmonary ventilation. Strong correlation between CAVI and haSTART indices and high consistency between both indices indicates the similarity of the results of PWV corrected by BP level.

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