Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes

<p>Abstract</p> <p>Background</p> <p>In comparison to the well established changes in compliance that occur at the large vessel level in diabetes, much less is known about the changes in compliance of the cardiovascular system at the end-organ level. The aim of this stu...

Full description

Bibliographic Details
Main Authors: Matthews D Geoffrey, Hao Huming, Smith Trudy J, Panagiotopoulos Sianna, Thomas Merlin C, MacIsaac Richard J, Jerums George, Burrell Louise M, Srivastava Piyush M
Format: Article
Language:English
Published: BMC 2008-05-01
Series:Cardiovascular Diabetology
Online Access:http://www.cardiab.com/content/7/1/15
_version_ 1819058572571443200
author Matthews D Geoffrey
Hao Huming
Smith Trudy J
Panagiotopoulos Sianna
Thomas Merlin C
MacIsaac Richard J
Jerums George
Burrell Louise M
Srivastava Piyush M
author_facet Matthews D Geoffrey
Hao Huming
Smith Trudy J
Panagiotopoulos Sianna
Thomas Merlin C
MacIsaac Richard J
Jerums George
Burrell Louise M
Srivastava Piyush M
author_sort Matthews D Geoffrey
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>In comparison to the well established changes in compliance that occur at the large vessel level in diabetes, much less is known about the changes in compliance of the cardiovascular system at the end-organ level. The aim of this study was therefore to examine whether there was a correlation between resistance of the intrarenal arteries of the kidney and compliance of the left ventricle, as estimated by measurements of diastolic function, in subjects with type 2 diabetes.</p> <p>Methods</p> <p>We studied 167 unselected clinic patients with type 2 diabetes with a kidney duplex scan to estimate intrarenal vascular resistance, i.e. the resistance index (RI = peak systolic velocity-minimum diastolic velocity/peak systolic velocity) and a transthoracic echocardiogram (TTE) employing tissue doppler studies to document diastolic and systolic ventricular function.</p> <p>Results</p> <p>Renal RI was significantly higher in subjects with diastolic dysfunction (0.72 ± 0.05) when compared with those who had a normal TTE examination (0.66 ± 0.06, p < 0.01). Renal RI values were correlated with markers of diastolic dysfunction including the E/Vp ratio (r = 0.41, p < 0.001), left atrial area (r = 0.36, p < 0.001), the E/A ratio (r = 0.36, p < 0.001) and the E/E' ratio (r = 0.31, p < 0.001). These associations were independent of systolic function, hypertension, the presence and severity of chronic kidney disease, the use of renin-angiotensin inhibitors and other potentially confounding variables.</p> <p>Conclusion</p> <p>Increasing vascular resistance of the intrarenal arteries was associated with markers of diastolic dysfunction in subjects with type 2 diabetes. These findings are consistent with the hypothesis that vascular and cardiac stiffening in diabetes are manifestations of common pathophysiological mechanisms.</p>
first_indexed 2024-12-21T13:57:20Z
format Article
id doaj.art-1bd4a7078b234d74997600bba9dfa69a
institution Directory Open Access Journal
issn 1475-2840
language English
last_indexed 2024-12-21T13:57:20Z
publishDate 2008-05-01
publisher BMC
record_format Article
series Cardiovascular Diabetology
spelling doaj.art-1bd4a7078b234d74997600bba9dfa69a2022-12-21T19:01:29ZengBMCCardiovascular Diabetology1475-28402008-05-01711510.1186/1475-2840-7-15Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetesMatthews D GeoffreyHao HumingSmith Trudy JPanagiotopoulos SiannaThomas Merlin CMacIsaac Richard JJerums GeorgeBurrell Louise MSrivastava Piyush M<p>Abstract</p> <p>Background</p> <p>In comparison to the well established changes in compliance that occur at the large vessel level in diabetes, much less is known about the changes in compliance of the cardiovascular system at the end-organ level. The aim of this study was therefore to examine whether there was a correlation between resistance of the intrarenal arteries of the kidney and compliance of the left ventricle, as estimated by measurements of diastolic function, in subjects with type 2 diabetes.</p> <p>Methods</p> <p>We studied 167 unselected clinic patients with type 2 diabetes with a kidney duplex scan to estimate intrarenal vascular resistance, i.e. the resistance index (RI = peak systolic velocity-minimum diastolic velocity/peak systolic velocity) and a transthoracic echocardiogram (TTE) employing tissue doppler studies to document diastolic and systolic ventricular function.</p> <p>Results</p> <p>Renal RI was significantly higher in subjects with diastolic dysfunction (0.72 ± 0.05) when compared with those who had a normal TTE examination (0.66 ± 0.06, p < 0.01). Renal RI values were correlated with markers of diastolic dysfunction including the E/Vp ratio (r = 0.41, p < 0.001), left atrial area (r = 0.36, p < 0.001), the E/A ratio (r = 0.36, p < 0.001) and the E/E' ratio (r = 0.31, p < 0.001). These associations were independent of systolic function, hypertension, the presence and severity of chronic kidney disease, the use of renin-angiotensin inhibitors and other potentially confounding variables.</p> <p>Conclusion</p> <p>Increasing vascular resistance of the intrarenal arteries was associated with markers of diastolic dysfunction in subjects with type 2 diabetes. These findings are consistent with the hypothesis that vascular and cardiac stiffening in diabetes are manifestations of common pathophysiological mechanisms.</p>http://www.cardiab.com/content/7/1/15
spellingShingle Matthews D Geoffrey
Hao Huming
Smith Trudy J
Panagiotopoulos Sianna
Thomas Merlin C
MacIsaac Richard J
Jerums George
Burrell Louise M
Srivastava Piyush M
Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes
Cardiovascular Diabetology
title Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes
title_full Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes
title_fullStr Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes
title_full_unstemmed Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes
title_short Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes
title_sort association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes
url http://www.cardiab.com/content/7/1/15
work_keys_str_mv AT matthewsdgeoffrey associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes
AT haohuming associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes
AT smithtrudyj associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes
AT panagiotopoulossianna associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes
AT thomasmerlinc associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes
AT macisaacrichardj associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes
AT jerumsgeorge associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes
AT burrelllouisem associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes
AT srivastavapiyushm associationbetweenintrarenalarterialresistanceanddiastolicdysfunctionintype2diabetes