medicina61巻8号

2024年07月発行

特集 “とりあえずスタチン”から脱却！—動脈硬化性疾患一次予防・最新の考え方 診断

動脈硬化性疾患における画像診断の進歩①—心臓足首血管指数（CAVI）/脈波伝播速度（PWV）

著者： 齋木厚人¹

所属機関： ¹東邦大学医療センター佐倉病院糖尿病内分泌代謝センター

ページ範囲：P.1218 - P.1223

Point
◎心臓足首血管指数（CAVI）は血圧依存性のないstiffness parameter β理論に基づいた，血管固有の硬さを測定しうる血管機能検査法である．
◎CAVIは年齢とともに高くなり，女性より男性で高く，動脈硬化性疾患を有する患者で高い．
◎CAVIは糖尿病，高血圧，脂質異常症を有する患者で高く，それらに対する治療で低下する．
◎CAVIは肥満度の指標であるBMIと負の相関を示すが，腹部肥満の指標である内臓脂肪面積やa body shape index（ABSI）とは正相関する．

参考文献

1）Shirai K, et al：A novel blood pressure-independent arterial wall stiffness parameter；Cardio-ankle vascular index（CAVI）. J Atheroscler Thromb 13：101-107, 2006 PMID 16733298

2）Hayashi K, et al：Stiffness and elastic behavior of human intracranial and extracranial arteries. J Biomech 13：175-184, 1980 PMID 7364778

3）Tanaka A, et al：Physiological diagnostic criteria for vascular failure. Hypertension 72：1060-1071, 2018 PMID 30354826

4）Shirai K, 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 18：49-55, 2011 PMID 21071883

5）Saiki A, et al：New horizons of arterial stiffness developed using cardio-ankle vascular index（CAVI）. J Atheroscler Thromb 27：732-748, 2020 PMID 32595186

6）Nakamura K, et al：Cardio-ankle vascular index is a candidate predictor of coronary atherosclerosis. Circ J 72：598-604, 2008 PMID 18362432

7）Sato Y, et al：Cardio-ankle vascular index is independently associated with future vardiovascular events in outpatients with metabolic disorders. J Atheroscler Thromb 23：596-605, 2016 PMID 26632164

8）Otsuka K, et al：Serial assessment of arterial stiffness by cardio-ankle vascular index for prediction of future cardiovascular events in patients with coronary artery disease. Hypertens Res 37：1014-1020, 2014 PMID 25007768

9）Miyoshi T, et al：Predictive value of the cardio-ankle vascular index for cardiovascular events in patients at cardiovascular risk. J Am Heart Assoc 10：e020103, 2021 PMID 34369198

10）Uzui H, et al：Acarbose treatments improve arterial stiffness in patients with type 2 diabetes mellitus. J Diabetes Investig 2：148-153, 2011 PMID 24843474

11）Ohira M, et al：Improvement of postprandial hyperglycemia and arterial stiffness upon switching from premixed human insulin 30/70 to biphasic insulin aspart 30/70. Metabolism 60：78-85, 2011 PMID 20667560

12）Nagayama D, et al：Effects of vildagliptin, a dipeptidyl peptidase-4 inhibitor, on the parameters of glucose metabolism and the cardio-ankle vascular index in individuals with type 2 diabetes. J Clin Med 13：481, 2024 PMID 38256615

13）Ohira M, et al：Pioglitazone improves the cardio-ankle vascular index in patients with type 2 diabetes mellitus treated with metformin. Diabetes Metab Syndr Obes 7：313-319, 2014 PMID 25092992

14）Nagayama D, et al：Improvement of cardio-ankle vascular index by glimepiride in type 2 diabetic patients. Int J Clin Pract 64：1796-1801, 2010 PMID 20946343

15）Bekki M, et al：Switching dipeptidyl peptidase-4 inhibitors to tofogliflozin, a selective inhibitor of sodium-glucose cotransporter 2 improves arterial stiffness evaluated by cardio-ankle vascular index in patients with type 2 diabetes；A pilot study. Curr Vasc Pharmacol 17：411-420, 2019 PMID 29766812

16）Nagayama D, et al：Effects of body weight reduction on cardio-ankle vascular index（CAVI）. Obes Res Clin Pract 7：e139-145, 2013 PMID 24331775

17）Nagayama D, et al：Lipid parameters are independently associated with cardio-ankle vascular index（CAVI）in healthy Japanese subjects. J Atheroscler Thromb 25：621-633, 2018 PMID 29332863

18）Suzuki M, et al：Frequency of coronary artery stenosis in patients with asymptomatic familial hypercholesterolemia and its association with carotid intimal thickness and cardio-ankle vascular index. Research Reports in Clinical Cardiology 7：83-90, 2016

19）Saiki A, et al：CAVI-lowering effect of pitavastatin may be involved in the prevention of cardiovascular disease；Subgroup analysis of the TOHO-LIP. J Atheroscler Thromb 28：1083-1094, 2021 PMID 33342941

20）Miyashita Y, et al：Effects of pitavastatin, a 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitor, on cardio-ankle vascular index in type 2 diabetic patients. J Atheroscler Thromb 16：539-545, 2009 PMID 19907100

21）Nagayama D, et al：Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects；A cross-sectional study. Vasc Health Risk Manag 13：1-9, 2016 PMID 28053538

22）Park HE, et al：Cardio-ankle vascular index reflects coronary atherosclerosis in patients with abnormal glucose metabolism；Assessment with 256 slice multi-detector computed tomography. J Cardiol 60：372-376, 2012 PMID 22890071

23）Krakauer NY, Krakauer JC：A new body shape index predicts mortality hazard independently of body mass index. PLoS One 7：e39504, 2012 PMID 22815707

24）Nagayama D, et al：New index of abdominal obesity, a body shape index, is BMI-independently associated with systemic arterial stiffness in real-world Japanese population. Int J Clin Pharmacol Ther 58：709-717, 2020 PMID 32831165

25）Satoh N, 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 31：1921-1930, 2008 PMID 19015600