Informativity of Indicators of the Arterial Wall Stiffness for Screening Studies

Objective: comparative assessment of informativity of parameters of arterial wall stiffness - the cardio-ankle vascular index (CAVI), the augmentation index (AI) - for solution of problems of screening patients being under threat of realization of complex impact of metabolic syndrome (MS) and elevated vessel wall stiffness, both creators and markers of high risk of severe cardiovascular complications. Materials and methods. We examined mining industry employees (n=206) with cardiac risk factors (arterial hypertension, abdominal obesity, and smoking). Comparative group comprised 75 employees of the same enterprise without above-mentioned risk factors. Studies of arterial wall stiffness included determination of CAVI and AI. The sensitivity, specificity and accuracy of the screening method were calculated. Results. CAVI and AI parameters had different sensitivity, specificity and accuracy for identifying patients at risk of cardiovascular complications. AI was 2 times more sensitive than CAVI during examination of patients with only clinical and anamnestic cardiovascular risk markers and patients with clinical-anamnestic and laboratory risk markers. Specificity of AI was lower than specificity of CAVI and attained only 34.4% in patients with clinical-anamnestic and laboratory risk factors. At the same time, specificity of CAVI in these patients reached 86.2%. Accuracy of AI for screening study was 1.4 times higher than that of CAVI in patients with only clinical-anamnestic risk markers, and 1.6 times higher in patients with both clinical-anamnestic and laboratory risk markers. Moreover, after comparing patient groups with individually high and normal CAVI and AI, we found the differences in metabolic laboratory risk factors (glucose, total cholesterol, triglycerides and the Atherogenic Index) only for AI.Conclusion. Parameters of arterial stiffness have different informative value for screening of patients with clinical-anamnestic or laboratory risk factors. AI compared with CAVI is 2 times more sensitive and 1.6 times more accurate but has lower specificity for risk factor screening among patients being under threat of realization of complex impact of MS and elevated vessel wall stiffness.

жесткость артериальной стенки, факторы риска, скрининг, объемная сфигмоманометрия, arterial wall stiffness, risk factors, screening, volume sphygmomanometry

1. Orlova I., Ageev F., Nuraliev E. Arterial Stiffness is Predictor Cardiovascular Events in Men with Coronary Artery Disease. Artery Research 2007;1 (2):59-60. https://doi.org/10.1016/j. artres. 2007.07.087.

2. Milyagin V. A., Milyagina I. V., Abramenkova N. Yu. i dr. Neinvazivnye metody issledovaniya magistral'nykh sosudov. Smolensk: Izdatel'stvo Smolenskaya gorodskaya tipografiya 2012; 224s

3. Laurent S., Boutouyrie P., Asmar R. et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001;37:1236-1241. https://doi.org/10.1161/01. HYP. 37.5.1236.

4. Townsend R. R., Wilkinson, I. B., Schiffrin E. L. et al. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness. A Scientific Statement from the American Heart Association. J. Hypertension 2015;3:698-722. https://doi.org/10.1161 /HYP. 0000000000000033.

5. Chazova I. E., Ratova L. G., Boitsov S. A., Nebieridze D. V. Diagnostika i lechenie arterial'noi gipertenzii. Rekomendatsii Rossiiskogo meditsinskogo obshchestva po arterial'noi gipertonii i Vserossiiskogo nauchnogo obshchestva kardiologov. Sistemnye gipertenzii 2010;3:5-26

6. Rogoza A. N., Balakhonova T. V., Chikhladze N. M. Sovremennye metody otsenki sostoyaniya sosudov u bol'nykh arterial'noi gipertoniei. M.: Atmosfera 2008; 72 s

7. ESH/ESC Guidelines for the management of arterial hypertension. Ue Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) European Heart J 2013;34:2159-2219. https://doi.org/10.1093/eurheartj/eht151

8. 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):924-938. https://doi.org/10.5551/jat. 7716

9. Cheuk-Kwan Sun. Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness. Integrated Blood Pressure Control 2013;6:27-38. https://doi.org/10.2147/IBPC. S34423

10. Shimizu M., Kario K. Role of the augmentation index in hypertension. ^erapeutic Advances in Cardiovascular Disease 2008;2:25 35. https://doi.org/10.1177/1753944707086935

11. Vasil'ev A. Yu., Malyi A. Yu., Serova N. S. Analiz dannykh luchevykh metodov issledovaniya na osnove printsipov dokazatel'noi meditsiny. M.: GEOTAR-Media 2008; 34 s