The role of arterial stiffness as assessed by the cardio-ankle vascular index in patients with chronic obstructive pulmonary disease

Background: Arteriosclerosis and cardiovascular disease (CVD) can greatly affect the progression of chronic obstructive pulmonary disease (COPD). However, standardized methods for evaluating arteriosclerosis in COPD have not been established. The cardio-ankle vascular index (CAVI) is a reliable marker of arterial stiffness and a potential marker for assessing arteriosclerosis. This study aimed to examine the associations between the CAVI and clinical parameters and to evaluate its predictive value for clinical outcomes in COPD. Methods: This retrospective, observational study included patients with COPD who underwent CAVI assessment. The relationships between CAVI and clinical parameters were analysed. The patients were stratified into two groups according to the median CAVI. We examined whether an elevated CAVI was associated with clinical outcomes and evaluated its predictive value for poor clinical outcomes, including disability (modified Rankin Scale score >= 4) or death. Results: A total of 102 patients were analysed (median age: 74 years; 94.1 % men). The median CAVI was 9.4. The CAVI was positively correlated with the percentage of a low attenuation area on computed tomography and negatively correlated with FEV1 and body mass index, independent of age and the smoking index. An elevated CAVI (>9.4) was associated with severe exacerbations and poor clinical outcomes. A multivariate analysis identified the CAVI as an independent predictor of poor clinical outcomes, regardless of age, severity of dyspnoea, and airflow obstruction. Conclusion: Arterial stiffness assessed by the CAVI is a useful marker of COPD severity and may serve as a prognostic indicator and therapeutic target for improving COPD management.