The impact of the cardio-ankle vascular index on left ventricular structure and function

Left ventricular (LV) afterload is a major determinant of cardiac stress and a key factor for the development of hypertensive heart disease and load-induced ventricular dysfunction. Office brachial blood pressure (BP) is an established predictor of LV mass (with BP components in the following order: systolic > mean > pulse > diastolic),¹ although the degree of correlation is rather weak and only slightly improved by the use of 24-h¹ or central^2,3 BP. Other markers of ventricular-vascular interaction may provide complementary information on the impact of the large vessels on LV structure and function. The present short review examines the impact of different markers of large-artery functional properties, including carotid-femoral pulse wave velocity (PWV) and the novel cardio-ankle vascular index (CAVI), on major prognostically adverse measures of LV involvement such as increased LV mass⁴ and systolic dysfunction.⁵