{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:46:48Z","timestamp":1777470408999,"version":"3.51.4"},"reference-count":52,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Japan Society for the Promotion of Science KAKENHI","award":["JP 19K08558"],"award-info":[{"award-number":["JP 19K08558"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Heart failure (HF) is becoming an increasingly common issue worldwide and is associated with significant morbidity and mortality, making its prevention an important clinical goal. The criteria evaluated using non-invasive modalities such as coronary artery calcification, the ankle-brachial index, and carotid intima-media thickness have been proven to be effective in determining the relative risk of atherosclerotic cardiovascular disease. Notably, risk assessments using these modalities have been proven to be superior to the traditional risk predictors of cardiovascular disease. However, the ability to assess HF risk has not yet been well-established. In this review, we describe the clinical significance of such non-invasive modalities of atherosclerosis assessments and examine their ability to assess HF risk. The predictive value could be influenced by the left ventricular ejection fraction. Specifically, when the ejection fraction is reduced, its predictive value increases because this condition is potentially a result of coronary artery disease. In contrast, using these measures to predict HF with a preserved ejection fraction may be difficult because it is a heterogeneous condition. To overcome this issue, further research, especially on HF with a preserved ejection fraction, is required.<\/jats:p>","DOI":"10.3390\/ijms24031925","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T02:51:37Z","timestamp":1674096697000},"page":"1925","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Are Non-Invasive Modalities for the Assessment of Atherosclerosis Useful for Heart Failure Predictions?"],"prefix":"10.3390","volume":"24","author":[{"given":"Kazuhiro","family":"Osawa","sequence":"first","affiliation":[{"name":"Department of General Internal Medicine 3, Kawasaki Medical School General Medical Center, Okayama 700-0821, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9039-3439","authenticated-orcid":false,"given":"Toru","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1016\/j.jacc.2021.12.011","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"79","author":"Heidenreich","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.1016\/j.jacc.2019.02.057","article-title":"10-Year Risk Equations for Incident Heart Failure in the General Population","volume":"73","author":"Khan","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1161\/CIRCHEARTFAILURE.114.001896","article-title":"Population risk prediction models for incident heart failure: A systematic review","volume":"8","author":"Greene","year":"2015","journal-title":"Circ. Heart Fail."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1161\/CIRCIMAGING.113.000341","article-title":"Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: Clinical risk scores are not sufficient to define primary prevention treatment strategies among asymptomatic patients","volume":"7","author":"Blaha","year":"2014","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1016\/j.jcmg.2012.03.016","article-title":"Coronary calcification and the risk of heart failure in the elderly: The Rotterdam Study","volume":"5","author":"Leening","year":"2012","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00392-009-0104-3","article-title":"Association of coronary artery calcium and congestive heart failure in the general population: Results of the Heinz Nixdorf Recall study","volume":"99","author":"Kalsch","year":"2010","journal-title":"Clin. Res. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.atherosclerosis.2021.09.028","article-title":"Ankle-brachial index and subsequent risk of incident and recurrent cardiovascular events in older adults: The Atherosclerosis Risk in Communities (ARIC) study","volume":"336","author":"Wang","year":"2021","journal-title":"Atherosclerosis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e000797","DOI":"10.1161\/JAHA.114.000797","article-title":"Carotid intima-media thickness is associated with incident heart failure among middle-aged whites and blacks: The Atherosclerosis Risk in Communities study","volume":"3","author":"Effoe","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.amjcard.2021.02.020","article-title":"Comparison of the Relation of Carotid Intima-Media Thickness With Incident Heart Failure With Reduced Versus Preserved Ejection Fraction (from the Multi-Ethnic Study of Atherosclerosis [MESA])","volume":"148","author":"Aladin","year":"2021","journal-title":"Am. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.1093\/eurheartj\/ehy217","article-title":"Ten-year association of coronary artery calcium with atherosclerotic cardiovascular disease (ASCVD) events: The multi-ethnic study of atherosclerosis (MESA)","volume":"39","author":"Budoff","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1001\/jama.2012.9624","article-title":"Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals","volume":"308","author":"Yeboah","year":"2012","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e005253","DOI":"10.1161\/JAHA.116.005253","article-title":"Progression of Coronary Artery Calcium and Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis","volume":"6","author":"Bakhshi","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1056\/NEJMoa072100","article-title":"Coronary calcium as a predictor of coronary events in four racial or ethnic groups","volume":"358","author":"Detrano","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.jacc.2008.07.072","article-title":"Coronary calcium predicts events better with absolute calcium scores than age-sex-race\/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis)","volume":"53","author":"Budoff","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2232","DOI":"10.1093\/eurheartj\/eht508","article-title":"Impact of coronary artery calcium on coronary heart disease events in individuals at the extremes of traditional risk factor burden: The Multi-Ethnic Study of Atherosclerosis","volume":"35","author":"Silverman","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jacc.2013.02.092","article-title":"A novel paradigm for heart failure with preserved ejection fraction: Comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation","volume":"62","author":"Paulus","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s00380-015-0645-5","article-title":"Association between coronary artery calcification and left ventricular diastolic dysfunction in elderly people","volume":"31","author":"Osawa","year":"2016","journal-title":"Heart Vessel."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e009228","DOI":"10.1161\/CIRCIMAGING.119.009228","article-title":"Coronary Artery Calcium From Early Adulthood to Middle Age and Left Ventricular Structure and Function","volume":"12","author":"Yared","year":"2019","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Castro-Diehl, C., Song, R.J., Mitchell, G.F., McManus, D., Cheng, S., Vasan, R.S., and Xanthakis, V. (2020). Association of subclinical atherosclerosis with echocardiographic indices of cardiac remodeling: The Framingham Study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0233321"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1536\/ihj.18-355","article-title":"Coronary Artery Calcium Is Associated with Left Ventricular Diastolic Function Independent of Myocardial Ischemia","volume":"60","author":"Nitta","year":"2019","journal-title":"Int. Heart J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1016\/j.amjcard.2017.07.089","article-title":"Usefulness of Coronary Artery Calcium to Predict Heart Failure With Preserved Ejection Fraction in Men Versus Women (from the Multi-Ethnic Study of Atherosclerosis)","volume":"120","author":"Sharma","year":"2017","journal-title":"Am. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/00126097-200302000-00002","article-title":"Relation of coronary artery calcium to left ventricular mass and geometry in patients with essential hypertension","volume":"8","author":"Altunkan","year":"2003","journal-title":"Blood Press Monit."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.amjcard.2020.08.017","article-title":"Effect of Progression of Valvular Calcification on Left Ventricular Structure and Frequency of Incident Heart Failure (from the Multiethnic Study of Atherosclerosis)","volume":"134","author":"Fashanu","year":"2020","journal-title":"Am. J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1093\/ehjci\/jeaa263","article-title":"Prevalence and clinical implications of valvular calcification on coronary computed tomography angiography","volume":"22","author":"Williams","year":"2021","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_25","first-page":"e686","article-title":"2016 AHA\/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"135","author":"Gornik","year":"2017","journal-title":"Circulation"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1001\/jama.300.2.197","article-title":"Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: A meta-analysis","volume":"300","author":"Fowkes","year":"2008","journal-title":"JAMA"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.jchf.2014.05.008","article-title":"Heart failure risk across the spectrum of ankle-brachial index: The ARIC study (Atherosclerosis Risk In Communities)","volume":"2","author":"Gupta","year":"2014","journal-title":"JACC Heart Fail."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1177\/1358863X19870602","article-title":"Ankle-brachial index and incident heart failure with reduced versus preserved ejection fraction: The Multi-Ethnic Study of Atherosclerosis","volume":"24","author":"Prasada","year":"2019","journal-title":"Vasc. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s00380-016-0873-3","article-title":"Prognostic value of ankle brachial index for future incident heart failure in patients without previous heart failure: Data from the impressive predictive value of ankle brachial index for clinical long term outcome in patients with cardiovascular disease examined by ABI study","volume":"32","author":"Nishimura","year":"2017","journal-title":"Heart Vessel."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.jvs.2008.06.005","article-title":"The association between elevated ankle systolic pressures and peripheral occlusive arterial disease in diabetic and nondiabetic subjects","volume":"48","author":"Aboyans","year":"2008","journal-title":"J. Vasc. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1024\/0301-1526\/a000289","article-title":"The association of ankle brachial index with left ventricular hypertrophy and left ventricular mass index: The Dong-gu study","volume":"42","author":"Choi","year":"2013","journal-title":"Vasa"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.jjcc.2021.07.011","article-title":"Arterial stiffness in health and disease: The role of cardio-ankle vascular index","volume":"78","author":"Miyoshi","year":"2021","journal-title":"J. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"101","DOI":"10.5551\/jat.13.101","article-title":"A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI)","volume":"13","author":"Shirai","year":"2006","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Namba, T., Masaki, N., Takase, B., and Adachi, T. (2019). Arterial Stiffness Assessed by Cardio-Ankle Vascular Index. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20153664"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e002189","DOI":"10.1161\/JAHA.115.002189","article-title":"Relation of Central Arterial Stiffness to Incident Heart Failure in the Community","volume":"4","author":"Tsao","year":"2015","journal-title":"J. Am. Heart Assoc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jjcc.2020.02.013","article-title":"Clinical significance of arterial stiffness as a factor for hospitalization of heart failure with preserved left ventricular ejection fraction: A retrospective matched case-control study","volume":"76","author":"Takagi","year":"2020","journal-title":"J. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e020103","DOI":"10.1161\/JAHA.120.020103","article-title":"Predictive Value of the Cardio-Ankle Vascular Index for Cardiovascular Events in Patients at Cardiovascular Risk","volume":"10","author":"Miyoshi","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.hlc.2018.04.286","article-title":"Correlation of Arterial Stiffness With Left Atrial Volume Index and Left Ventricular Mass Index in Young Adults: Evaluation by Coronary Computed Tomography Angiography","volume":"28","author":"Osawa","year":"2019","journal-title":"Heart Lung. Circ."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"249","DOI":"10.5551\/jat.1636","article-title":"Cardio-ankle vascular index is independently associated with the severity of coronary atherosclerosis and left ventricular function in patients with ischemic heart disease","volume":"17","author":"Miyoshi","year":"2010","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"261","DOI":"10.5551\/jat.E576","article-title":"Association of new arterial stiffness parameter, the cardio-ankle vascular index, with left ventricular diastolic function","volume":"15","author":"Sakane","year":"2008","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1620\/tjem.217.139","article-title":"Tissue Doppler echocardiography for predicting arterial stiffness assessed by cardio-ankle vascular index","volume":"217","author":"Masugata","year":"2009","journal-title":"Tohoku. J. Exp. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1536\/ihj.16-112","article-title":"Arterial Stiffness Is Significantly Associated With Left Ventricular Diastolic Dysfunction in Patients With Cardiovascular Disease","volume":"57","author":"Namba","year":"2016","journal-title":"Int. Heart J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1016\/S0735-1097(02)02159-9","article-title":"Cardiovascular remodeling is greater in isolated systolic hypertension than in diastolic hypertension in older adults: The Insufficienza Cardiaca negli Anziani Residenti (ICARE) a Dicomano Study","volume":"40","author":"Pini","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.diabres.2017.04.009","article-title":"Diabetes status modifies the association between carotid intima-media thickness and incident heart failure: The Atherosclerosis Risk in Communities study","volume":"128","author":"Effoe","year":"2017","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1161\/ATVBAHA.109.193490","article-title":"Carotid intima-media thickness, systemic inflammation, and incidence of heart failure hospitalizations","volume":"29","author":"Engstrom","year":"2009","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Liao, Y.Y., Gao, K., Fu, B.W., Yang, L., Zhu, W.J., Ma, Q., Chu, C., Yan, Y., Wang, Y., and Zheng, W.L. (2021). Risk factors for electrocardiographic left ventricular hypertrophy in a young Chinese general population: The Hanzhong adolescent cohort study. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-021-01966-y"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/j.echo.2010.08.021","article-title":"The distinct relationships of carotid plaque disease and carotid intima-media thickness with left ventricular function","volume":"23","author":"Chahal","year":"2010","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.atherosclerosis.2020.05.019","article-title":"Carotid intima-media thickness and subclinical left heart dysfunction in the general population","volume":"305","author":"Nakanishi","year":"2020","journal-title":"Atherosclerosis"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1161\/01.HYP.34.2.201","article-title":"Arterial stiffness and the development of hypertension. The ARIC study","volume":"34","author":"Liao","year":"1999","journal-title":"Hypertension"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Yuan, C., Wang, J., and Ying, M. (2016). Predictive Value of Carotid Distensibility Coefficient for Cardiovascular Diseases and All-Cause Mortality: A Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0152799"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1159\/000367645","article-title":"Common Carotid Artery Stiffness Is Associated with Left Ventricular Structure and Function and Predicts First Hospitalization for Acute Heart Failure","volume":"2","author":"Sung","year":"2014","journal-title":"Pulse"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1161\/CIRCRESAHA.117.311312","article-title":"Cardiovascular Event Prediction by Machine Learning: The Multi-Ethnic Study of Atherosclerosis","volume":"121","author":"Yang","year":"2017","journal-title":"Circ. Res."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/3\/1925\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:09:33Z","timestamp":1760119773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/3\/1925"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,18]]},"references-count":52,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijms24031925"],"URL":"https:\/\/doi.org\/10.3390\/ijms24031925","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,18]]}}}