Early stage detection of conduit artery endothelial dysfunction in patients with type 1 diabetes.
Flow-mediated dilatation evaluation using hand skin heating may possibly be more accurate than post-ischaemic hyperaemia to detect conduit artery endothelial dysfunction in type 1 diabetes. We measured in 24 type 1 diabetic patients (n=16 without microangiopathy) and 24 healthy matched subjects radial artery diameter (echotracking), blood flow and mean wall shear stress during heating and post-ischaemic hyperaemia. Compared with controls, flow-mediated dilatation was lower in diabetic patients during post-ischaemic hyperaemia and heating. However, in the subgroup of uncomplicated patients, a decreased flow-mediated dilatation was only apparent during heating (17.1+/-1.6% vs. 24.3+/-0.7%, p<0.05) but not during post-ischaemic hyperaemia (10.1+/-1.1% vs. 10.5+/-0.6%, NS). This was confirmed by the lower slope of the diameter-mean wall shear stress relationship in these patients in the absence of modification in endothelium-independent dilatation. We conclude that hand skin heating permits the early detection of conduit artery endothelial dysfunction in type 1 diabetic patients with normal response to post-ischaemic hyperaemia. This procedure could be useful to investigate the prognostic role of vascular dysfunction and the impact of vasculoprotective treatments in this patient population.
Bellien
Jeremy
J
University of Rouen, Rouen cedex, France.
Costentin
Agathe
A
Dutheil-Maillochaud
Benedicte
B
Iacob
Michele
M
Kuhn
Jean-Marc
JM
Thuillez
Christian
C
Joannides
Robinson
R
D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006225:Hand; D006358:Hot Temperature; D006801:Humans; D006940:Hyperemia; D008297:Male; D017534:Radial Artery / Q000503:physiopathology; D012867:Skin; D014664:Vasodilation