Correlation between Diastolic Function and Endothelial Function in Patients with Type 2 Diabetes and Hypertension

Abstract

Background:Endothelial dysfunction may be involved in the pathophysiology of cardiac abnormalities in patients with diabetes mellitus (DM). A correlation between endothelial dysfunction and diastolic dysfunction in patients with type 1 DM has been demonstrated, but this relationship has not been well investigated in type 2 DM.Objective:Compare groups of patients with type 2 DM and hypertension with and without diastolic dysfunction using endothelial function indexes, and to assess whether correlations exist between the diastolic function and the endothelial function indexes.Method:This was a cross-sectional study of 34 men and women with type 2 DM and hypertension who were aged between 40 and 70 years and were categorized based on assessments of their Doppler echocardiographic parameters as having normal (14 patients) and abnormal (20 patients) diastolic function. Flow-mediated dilatation (FMD) assessments of the brachial artery evaluated the patients’ endothelial function.Results:The mean maximum FMD was 7.15 ± 2.80% for the patients with diastolic dysfunction and it was 11.85 ± 4.77% for the patients with normal diastolic function (p = 0.004). Correlations existed between the maximum FMD and the E/e' ratio (p = 0.040, r = -0.354) and the early wave velocity (e') at the lateral mitral annulus (p = 0.002, r = 0.509).Conclusion:The endothelial function assessed by FMD was worse in hypertensive diabetic patients with diastolic dysfunction. There were correlations between the diastolic function indexes and the endothelial function indexes in our sample.

Crocin Improves the Endothelial Function Regulated by Kca3.1 Through ERK and Akt Signaling Pathways

“…Its physiological function where it tightly regulates vascular tone via establishing the balance between vasodilators and vasoconstrictors derived from endothelial cells [1, 14, 15, 29]. The endothelium-derived hyperpolarizing factor (EDHF) is considered to be as equally important as NO and PGI(2) in regulating vascular tone as well as endothelial function in both healthy and diseased states [14, 15, 25]. This factor, which is associated with the hyperpolarization of both endothelial and vascular smooth muscle cells, controls a endothelium-derived hyperpolarization (EDH) process mainly mediated by KCa3.1 [18, 25].…”

“…This factor, which is associated with the hyperpolarization of both endothelial and vascular smooth muscle cells, controls a endothelium-derived hyperpolarization (EDH) process mainly mediated by KCa3.1 [18, 25]. Endothelial dysfunction has long been recognized as an initiating event in the development of numerous cardiovascular diseases [14, 30]. This recognition is due to its influence on the consequential reduction in the synthesis and/or release of eNOS-mediated NO [29, 31], as well as damage to the EDHF dilator pathway [17, 25].…”

“…Then, the reduction of intracellular Ca 2+ may suppress the contraction of vascular smooth muscle, resulting in hypotension [5, 12, 13]. Conversely, hypertension is directly related to the endothelium and its function [1, 14, 15]. …”

“…The endothelium plays a crucial role in the regulation of vascular tone through the synthesis and release of vasodilators such as nitric oxide (NO), prostacyclin (PGI(2)) and endothelium-derived hyperpolarizing factor (EDHF). Vasoconstrictors from the endothelium such as endothelin-1, thromboxane A2 and angiotensin II, help maintain a metabolic balance between these substances under physiological conditions [1, 14, 15]. However, damage to the endothelium or endothelial dysfunction can harm this balance possibly leading to hypertension [1].…”

Echocardiographic parameters differentiating heart failure with preserved ejection fraction from asymptomatic left ventricular diastolic dysfunction

“…Elevated LV filling pressure results in heightened inspiratory drive, altered pulmonary gas exchange and reduced functional capacity . Second, lateral e' velocity was found to be significantly correlated with vascular stiffness and endothelia dysfunction . In this way, lateral e' velocity is associated with many features underlying the evolution and progression of HFpEF.…”