Relationship between left ventricular diastolic function and arterial stiffness in asymptomatic patients with diabetes mellitus.
Left ventricular (LV) diastolic dysfunction and increased arterial stiffness are common in patients with diabetes mellitus (DM). However, the relation between these two pathophysiological factors remains unclear. The aim of this study was to investigate the relationship between LV diastolic function and arterial stiffness as assessed with applanation tonometry. In 142 asymptomatic patients with DM (mean age 48 years, 75 (53 %) men, 72 (51 %) patients with type 2 DM) LV diastolic function was assessed with echocardiography. Arterial stiffness was evaluated measuring the aortic pulse wave velocity (PWV) whereas wave reflection was assessed measuring central systolic blood pressure (cSBP), central pulse pressure (cPP), and augmentation index (AIx) with applanation tonometry. Mean E/A ratio, E' and E/E' ratio were 1.1 ± 0.3, 8.1 ± 2.3 and 9.2 ± 3.3 cm/s, respectively. Mean PWV, mean cSBP, median cPP and mean AIx were 7.9 ± 2.4 m/s, 122 ± 17 mmHg, 40 [35-51] mmHg and 17.9 ± 12.1 %, respectively. PWV was independently associated with LV diastolic dysfunction grade (β = 0.76, p = 0.03). In contrast, measures of wave reflection, cPP, cSBP and AIx were independently related with E/A ratio, but not with the LV diastolic dysfunction grade. Parameters of arterial stiffness and wave reflection are associated with echocardiographic indices of LV diastolic function in asymptomatic patients with DM. Therapies that prevent progression of arterial stiffness and reduce late-systolic pressure overload may help to reduce the prevalence of LV diastolic dysfunction in this population.
Department of cardiology, C5-P, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands. c.j.roos@lumc.nl
Cornelis J
CJ
Roos
Dominique
D
Auger
Roxana
R
Djaberi
Eelco J
EJ
de Koning
Ton J
TJ
Rabelink
Alberto M
AM
Pereira
Jeroen J
JJ
Bax
Victoria
V
Delgado
J Wouter
JW
Jukema
Arthur J
AJ
Scholte
D000328:Adult; D058070:Asymptomatic Diseases; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left