Relationships between Cardio-Ankle Vascular Index and Peptides Related to Hypertensive Disorders of Pregnancy in Patients with Lower Extremity Arterial Disease.

Introduction: Cardio-ankle vascular index (CAVI), a blood pressure-independent measure of heart-ankle pulse wave velocity, is a relatively new indicator of arterial stiffness. The absolute value of the difference in right CAVI and left CAVI (diff-CAVI) has been proposed as a new indicator of leg ischemia in patients with lower extremity arterial disease (LEAD). The aim of this study was to elucidate the relationships between diff-CAVI and peptides related to hypertensive disorders of pregnancy (HDP), which have been proposed as biomarkers for leg ischemia in patients with LEAD.

Methods: The participants were 165 outpatients with LEAD who had already received medication therapy for LEAD. The relationships between diff-CAVI and serum levels of the seven HDP-related peptides, which were measured by mass spectrometry, were investigated.

Results: HDP-related peptides with m/z 2091 (P-2091) and m/z 2378 (P-2378) showed significant positive correlations with diff-CAVI, and odds ratios (ORs) for large diff-CAVI (≥1.05) of the 3rd vs. 1st tertile groups of P-2091 (OR [99.3% confidence interval]: 3.71 [1.24-11.15]) and P-2378 (OR: 4.46 [1.39-14.30]) were significantly higher (p < 0.01) than the reference level. The associations of P-2091 and P-2378 with diff-CAVI were shown to be independent of age, gender, habit of smoking, history of diabetes, BMI, and blood pressure in multivariate analyses. The other peptides with m/z 2081, 2127, 2209, 2858, and 3156 did not show significant associations with diff-CAVI.

Conclusion: P-2091 and P-2378 were associated with diff-CAVI and are thought to be useful indicators of leg ischemia in patients with LEAD.