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Aims:  We aimed to assess the associations of CAVI with exercise capacity in heart failure (HF) patients. In addition, we further examined their prognosis.   Methods:  We collected the clinical data of 223 patients who had been hospitalized for decompensated HF and had undergone both CAVI and cardiopulmonary exercise testing.   Results:  For the prediction of an impaired peak oxygen uptake (VO 2 ) of < 14 mL/kg/min, receiver-operating characteristic curve demonstrated that the cutoff value of CAVI was 8.9. In the multivariate logistic regression analysis for predicting impaired peak VO 2 , high CAVI was found to be an independent factor (odds ratio 2.343,  P  = 0.045). We divided these patients based on CAVI: the low-CAVI group (CAVI < 8.9,  n  = 145) and the high-CAVI group (CAVI ≥ 8.9,  n  = 78). Patient characteristics and post-discharge cardiac events were compared between the two groups. The high-CAVI group was older (69.0 vs. 58.0 years old,  P  < 0.001) and had lower body mass index (23.0 vs. 24.1 kg/m 2 ,  P  = 0.013). During the post-discharge follow-up period of median 1,623 days, 58 cardiac events occurred. The Kaplan–Meier analysis demonstrated that the cardiac event rate was higher in the high-CAVI group than in the low-CAVI group (log–rank  P  = 0.004). The multivariate Cox proportional hazard analysis revealed that high CAVI was an independent predictor of cardiac events (hazard ratio 1.845,  P  = 0.035).   Conclusion:  High CAVI is independently associated with impaired exercise capacity and a high cardiac event rate in HF patients.

Cardio-Ankle Vascular Index Reflects Impaired Exercise Capacity and Predicts Adverse Prognosis in Patients With Heart Failure