| Summary: | Objective: To investigate the relationship between arterial function and cardiac, especially left ventricular (LV) diastolic, function, in people at risk of or with type 2 diabetes (T2DM).
Design and method: 64 patients (48% non-European) participated in the study. Cardiac indices were obtained by 2-dimensional echocardiography, aortic pulse wave velocity (PWV) and augmentation index (AIx) were measured with an Arteriograph, cardio ankle vascular index (CAVI), nominally independent of pressure, was obtained using a VaSera device.
Results: Mean age was 59 y, 83% with T2DM, 84% hypertension, 12% previous cardiovascular events. Regressions for AIx with LV mass index (mean 51.2 g/m2.7) and left atrium volume index (β(SE)) were 0.52 (0.16) and 1.43 (0.4), p<0.002. Tissue Doppler indices (TDI) of diastolic function, E′ septal and E′ lateral waves were inversely related with AIx (−2.94 (0.9) and −2.14 (0.8)) as they were with CAVI (left, −0.2 (0.07) and −0.27 (0.05)) (all p<0.01), but the E/E′ ratio was not. Similarly, TDI for systolic function, S′, was related with AIx (−3.7 (1.1)) and with CAVI (0.21 (0.1))(p<0.05). In multiple regression models these relationships were still significant, when including age, gender, BMI, diabetic status and ethnicity, for cardiac structure and function (p<0.05), as with CAVI measures (p<0.05). There was no relationship with aortic PWV.
Conclusion: In patients at risk of or with T2DM, pressure augmentation is related to cardiac remodeling and diastolic function while a mainly pressure-independent index of stiffness of the aorta, femoral and tibial artery (CAVI) is associated with TDI of diastolic function.
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