title: Magnetic resonance assessment of aortic pulse wave velocity, aortic distensibility, and cardiac function in uncomplicated type 2 diabetes mellitus.
abstract: BACKGROUND
  Type 2 diabetes mellitus (DM2) may augment arterial stiffening and thereby modulates left ventricular (LV) function. Cardiovascular magnetic resonance (CMR) is well suited to assess aortic pulse wave velocity (PWV) and aortic distensibility, both markers of arterial stiffness, without the use of geometric assumptions. Furthermore, CMR is a reliable method for assessing left ventricular (LV) function. The purpose of this study was to assess LV function, PWV, and aortic distensibility in patients with DM2 using MR.
  
  
  METHODS
  Fourteen patients with well controlled, uncomplicated DM2, and 16 age and gender matched healthy subjects were included. PWV was calculated based on MR velocity mapping at two predefined aortic locations. Aortic distensibility was measured in the mid ascending aorta. LV volumes were measured by fast gradient-echo imaging to assess systolic function. Furthermore, mitral inflow was measured by MR velocity mapping to assess diastolic LV function.
  
  
  RESULTS
  Mean PWV was higher in patients as compared to healthy subjects (6.83 +/- 1.60 m/s vs. 5.65 +/- 0.75 m/s, p < 0.05). This difference was independent of blood pressure. PWV correlated significantly (p < 0.05) with fasting plasma glucose and insulin levels. Aortic distensibility was lower in patients as compared to healthy subjects (4.50 x 10(- 3)+/- 2.24 x 10(- 3) mmHg(- 1) vs. 7.42 x 10(- 3)+/- 3.34 x 10(- 3) mmHg(- 1), p < 0.05). Distensibility correlated negatively with PWV and positively with LV diastolic function (p < 0.05).
  
  
  CONCLUSIONS
  A combined CMR assessment of aortic PWV, aortic distensibility, and heart function reveals abnormal PWV and distensibility in patients with DM2, independent of blood pressure. Furthermore, aortic distensibility correlates with diastolic left ventricular function.
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. r.w.van_der_meer@lumc.nl
authors.forename: Rutger W
authors.initials: RW
authors.lastname: van der Meer
authors.forename: Michaela
authors.initials: M
authors.lastname: Diamant
authors.forename: Jos J M
authors.initials: JJ
authors.lastname: Westenberg
authors.forename: Joost
authors.initials: J
authors.lastname: Doornbos
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
mesh_terms: D001013:Aorta, Thoracic / Q000503:physiopathology*; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003971:Diastole; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D014655:Vascular Resistance; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*