Author + information
- Julio A. Chirinos,
- Patrick Segers,
- Thierry C. Gillebert,
- Marc De Buyzere,
- Caroline M. Van daele,
- Zubair A. Khan,
- Muhammad U. Khawar,
- Dirk De Bacquer,
- Ernst R. Rietzschel,
- Asklepios Investigators
Pulse pressure (PP), a strong predictor of cardiovascular risk in type-2 diabetes (T2DM), is affected by several hemodynamic factors. Little is known about the hemodynamic determinants of PP in T2DM or whether abnormalities in pulsatile hemodynamics are already present in individuals with impaired fasting glucose (IFG).
We studied adults with normal fasting glucose (n=1654), IFG (n=240) and T2DM (n=33). We measured carotid pressure, left ventricular outflow, aortic root diameter, carotid artery flow and distension in order to assess various potential determinants of central PP.
IFG was associated with a greater mean arterial pressure (MAP) but not with intrinsic aortic stiffening or abnormal pulsatile indices. After adjustment for age, gender and mean arterial pressure (Table), T2DM was associated with a higher aortic root elastance-thickness product (Eh), a greater carotid-femoral pulse wave velocity (PWV), and lower total arterial compliance and wave reflection magnitude. Aortic root diameter and carotid diameter, characteristic impedance, distensibility or Eh did not significantly differ between the groups.
T2DM' but not IFG, is associated with greater large artery stiffness, without abnormalities in aortic root diameter or carotid stiffness. T2DM is associated with a reduced reflection magnitude, which may indicate increased penetration of pulsatile energy to distal vascular beds.FG. † P<0.05, T2DM vs. normal FG. ‡ P<0.05, T2DM vs. IFG.
|Normal FG (n=1654)||Impaired FG (n=240)||type-2 diabetes (n=33)||P value|
|Total arterial compliance, mmHg.mL.m-2||1.02 (1.01–1.03)||1.01 (0.98–1.04)||0.89 (0.8–0.97)||0.012 †,‡|
|Aortic characteristic impedance, mmHg·ms·mL-1·m1.3||0.12 (0.12–0.13)||0.12 (0.12–0.13)||0.14 (0.13–0.15)||0.052|
|Ascending aortic Eh (kdyne/cm)||285 (275–296)||283 (256–312)||402 (309–523)||0.038 †,‡|
|Carotid-Femoral PWV (m/s)||6.6 (6.54–6.65)||6.57 (6.43–6.71)||7.34 (6.96–7.73)||0.001 †,‡|
|Reflected wave transit time (msec)||63 (62–64)||64 (62–66)||63 (58–69)||0.95|
|Reflection Magnitude||0.48 (0.48–0.48)||0.48 (0.47–0.48)||0.43 (0.4–0.46)||0.002 †,‡|
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Determinants and Modifiers of Arterial Stiffness
Abstract Category: 25. Prevention: Hypertension
Presentation Number: 1234-23
- 2013 American College of Cardiology Foundation