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 central2,3 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 largeartery 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