Principles and usefulness of the cardio-ankle vascular index (CAVI): a new global arterial stiffness index

Arterial stiffness has been reported as an independent predictor of morbidity and mortality in different populations. Although measurement of pulse wave velocity is considered the gold standard for the assessment of arterial stiffness, it has several limitations: sensitivity to the blood pressure level, complexity of the measurement procedure, the bias of distance determination, etc. Recently, the cardio-ankle vascular index (CAVI), based on the beta index, measured using the VaSera device, has been introduced as an index of arterial stiffness from the origin of the aorta to the ankle. Theoretically, this new parameter and device present some advantages such as a relative independency from the blood pressure level at the time of measurement, high reproducibility and sensitivity, and a user-friendly device with a simplified procedure. In this article, several methodological aspects and clinical applications of CAVI have been reviewed: the principles of CAVI, its normal values according to age and gender, the thresholds used for diagnosis, the effect of cardiovascular risk factors and diseases on CAVI, its prognostic value and its eventual improvement after treatment with non-pharmacological intervention and various pharmacological agents.