Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website http://www.cardiologyres.org

Case Report

Volume 10, Number 1, February 2019, pages 54-58

A Case Demonstrating the Cardio-Vascular Interaction by a New Cardio-Ankle Vascular Index During the Treatment of Concentric Hypertrophy

Figure 1. Clinical course of the patient. CAVI and LVMI were improved by blood pressure control and CPAP therapy for OSA. A: losartan; B: metformin; C: amlodipine; D: bisoprolol; E: spironolactone; F: telmisartan; CAVI: cardio ankle vascular index; LVMI: left ventricular mass index; BP: blood pressure; CPAP: continuous positive airway pressure; ECG: electrocardiogram.

Figure 2. Cardio-vascular interaction. Vascular function was closely related with left ventricular function. CAVI: cardio ankle vascular index; E/A: peak early diastolic filling velocity (E-wave)/peak atrial filling velocity (A-wave); E/e’: peak early diastolic filling velocity (E-wave)/spectral Doppler tissue velocities of the septal mitral annulus (e’); EF: ejection fraction; LVMI: left ventricular mass index; GLS: global longitudinal strain.

**Table 1.** Changes in Clinical Parameters
Clinical parameters	2006	① 2015	② 2015	③ 2015	④ 2016	⑤ 2017	⑥ 2018
SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; bpm: beats per minute; BNP: plasma brain natriuretic peptide; CTR: cardio-thoracic ratio; IVST: interventricular septal thickness; LVPWT: left ventricular posterior wall thickness; LVMI: left ventricular mass index; EF: ejection fraction; E/A: peak early diastolic filling velocity (E-wave)/peak atrial filling velocity (A-wave); E/e’: peak early diastolic filling velocity (E-wave)/spectral Doppler tissue velocities of the septal mitral annulus (e’); GLS: global longitudinal strain.
BW (kg)	75	75	73	73	73	77	78
SBP (mm Hg)	200	167	126	135	157	121	133
DBP (mm Hg)	110	100	78	84	95	78	81
HR (bpm)	70	76	73	68	62	70	7.2
Creatine (mg/dL)	0.63	0.65	1.07	1.05	0.89	0.93	0.92
Urinary protein	(-)	(2+)	(-)	(-)	(-)	(-)	(-)
HbA1c (%)	6.2	10.0		9.3	6.2	6.7	7.4
BNP (pg/mL)	5.9	151.2	6.1	7.8	78.5		< 5.8
CTR (%)	48	53	50		44		44
IVST (mm)	10	15	15	12	12	12	10
LVPWT (mm)	10	15	15	12	12	12	10
LVMI (g/m²)		128	110	95	87	95	72
EF (%)	59	62	62	68	73	65	70
E/A		0.73	1.05	0.89	1.16	1.45	0.98
E/e’		13.6	13.18	11.52	8.84	15.93	10.68
e’ (cm/s)		5.0	4.4	5.9	9.5	6.4	7.3
GLS (%)		-10.8	-8.9	-16.1	-18.4	-16.3	-20.4
CAVI		9.1	8.2	7.6	8.0	7.0	7.2

Table 1. Changes in Clinical Parameters

Clinical parameters

2006

① 2015

② 2015

③ 2015

④ 2016

⑤ 2017

⑥ 2018

SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; bpm: beats per minute; BNP: plasma brain natriuretic peptide; CTR: cardio-thoracic ratio; IVST: interventricular septal thickness; LVPWT: left ventricular posterior wall thickness; LVMI: left ventricular mass index; EF: ejection fraction; E/A: peak early diastolic filling velocity (E-wave)/peak atrial filling velocity (A-wave); E/e’: peak early diastolic filling velocity (E-wave)/spectral Doppler tissue velocities of the septal mitral annulus (e’); GLS: global longitudinal strain.

BW (kg)

SBP (mm Hg)

200

167

126

135

157

121

133

DBP (mm Hg)

110

100

HR (bpm)

7.2

Creatine (mg/dL)

0.63

0.65

1.07

1.05

0.89

0.93

0.92

Urinary protein

(-)

(2+)

(-)

HbA1c (%)

6.2

10.0

9.3

6.2

6.7

7.4

BNP (pg/mL)

5.9

151.2

6.1

7.8

78.5

< 5.8

CTR (%)

IVST (mm)

LVPWT (mm)

LVMI (g/m²)

128

110

EF (%)

E/A

0.73

1.05

0.89

1.16

1.45

0.98

E/e’

13.6

13.18

11.52

8.84

15.93

10.68

e’ (cm/s)

5.0

4.4

5.9

9.5

6.4

7.3

GLS (%)

-10.8

-8.9

-16.1

-18.4

-16.3

-20.4

CAVI

9.1

8.2

7.6

8.0

7.0

7.2