Aortic stiffness is associated with cardiac function and cerebral small vessel disease in patients with type 1 diabetes mellitus: assessment by magnetic resonance imaging.
OBJECTIVE
To evaluate, with the use of magnetic resonance imaging (MRI), whether aortic pulse wave velocity (PWV) is associated with cardiac left ventricular (LV) function and mass as well as with cerebral small vessel disease in patients with type 1 diabetes mellitus (DM).


METHODS
We included 86 consecutive type 1 DM patients (49 male, mean age 46.9 +/- 11.7 years) in a prospective, cross-sectional study. Exclusion criteria included aortic/heart disease and general MRI contra-indications. MRI of the aorta, heart and brain was performed for assessment of aortic PWV, as a marker of aortic stiffness, systolic LV function and mass, as well as for the presence of cerebral white matter hyperintensities (WMHs), microbleeds and lacunar infarcts. Multivariate linear or logistic regression was performed to analyse the association between aortic PWV and outcome parameters, with covariates defined as age, gender, mean arterial pressure, heart rate, BMI, smoking, DM duration and hypertension.


RESULTS
Mean aortic PWV was 7.1 +/- 2.5 m/s. Aortic PWV was independently associated with LV ejection fraction (ss = -0.406, P = 0.006), LV stroke volume (ss = -0.407, P = 0.001), LV cardiac output (ss = -0.458, P = 0.001), and with cerebral WMHs (P < 0.05). There were no independent associations between aortic stiffness and LV mass, cerebral microbleeds or lacunar infarcts.


CONCLUSIONS
Aortic stiffness is independently associated with systolic LV function and cerebral WMHs in patients with type 1 DM.
van Elderen
Saskia G C
SG
Department of Radiology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. s.g.c.van_elderen@lumc.nl
Brandts
A
A
Westenberg
J J M
JJ
van der Grond
J
J
Tamsma
J T
JT
van Buchem
M A
MA
Romijn
J A
JA
Kroft
L J M
LJ
Smit
J W A
JW
de Roos
A
A
D001013:Aorta, Thoracic / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014655:Vascular Resistance; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology*
D015415:Biomarkers