title: Assessment of arterial stiffness in patients with chronic lower extremity venous disease: An observational study.
abstract: OBJECTIVE
  Arterial stiffness is associated with major adverse cardiovascular events. Chronic venous insufficiency (CVI) is severe form of chronic venous disease (CVD). The aim of this study is to investigate arterial stiffness by cardio-ankle vascular index (CAVI) in patients with CVI.
  
  
  METHODS
  This observational and cross-sectional study involved 87 subjects with CVI and 86 healthy subjects. All subjects underwent ultrasonography examination. CAVI was measured by VaSera-1000 CAVI instrument.
  
  
  RESULTS
  High density lipoprotein cholesterol (HDL) was significantly lower in patients with CVI than controls (46.83 ± 9.25 mg/dl vs 51.33 ± 11.13 mg/dl, p = 0.004). Body mass index (BMI) was significantly higher in CVI patients than controls (28.53 ± 4.10 kg/m(2) vs 26.37 ± 5.16 kg/m(2), p = 0.003). Ankle brachial index (ABI) was significantly lower in patients with CVI compared to controls (1.08 ± 0.08 vs 1.14 ± 0.11, p < 0.001). CAVI was significantly higher in patients with CVI than controls (7.94 ± 1.37 vs 6.73 ± 1.16, p < 0.001). Mean arterial pressure (MAP) was significantly higher in patients with CVI than control group (105.41 ± 10.77 mmHg vs 99.70 ± 11.17 mmHg, p = 0.001). CAVI (p < 0.001, Odds ratio (OR) = 2.033, 95% Confidence interval (CI) = 1.493-2.768), ABI (p = 0.003, OR = 0.003, 95% CI = 0.001-0.137), female sex (p < 0.001, OR = 3.949, 95% CI = 1.613-9.663), and HDL (p < 0.001, OR = 0.923, 95% CI = 0.883-0.964) were the independent predictors of CVI. A CAVI value > 7.9 had a sensitivity 64.4% and a specificity of 94.7% for predicting the presence of CVI in ROC analysis (area under curve = 0.791, 95% CI = 0.723-0.849, p < 0.001).
  
  
  CONCLUSIONS
  CAVI is independently increased in CVI patients. Therefore CVI may be accepted a form of vascular sclerosis and vascular system should be evaluated in continuum not isolated.
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey ahmetaykan@yahoo.com.
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Aykan
authors.affiliation: Department of Emergency Medicine, Numune Training and Research Hospital, Trabzon, Turkey.
authors.forename: Seda
authors.initials: S
authors.lastname: Menteşe
authors.affiliation: Department of Cardiovascular Surgery, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Doğan
authors.affiliation: Department of Radiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: İsmail Gökhan
authors.initials: İG
authors.lastname: Çavuşoğlu
authors.affiliation: Department of Pharmacology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Duygun Altıntaş
authors.initials: DA
authors.lastname: Aykan
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycıoğlu
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gökdeniz
authors.affiliation: Department of Cardiovascular Surgery, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Menteşe
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055109:Ankle Brachial Index; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood; D002908:Chronic Disease; D035002:Lower Extremity / Q000098:blood supply / Q000503:physiopathology; D014463:Ultrasonography; D059289:Vascular Stiffness; D014689:Venous Insufficiency / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D008076:Cholesterol, HDL
keywords: CAVI; arterial stiffness; cardiac; chronic venous disease; insufficiency; varicose; vein