Diabetes Mellitus: Is It Protective against Aortic Root Dilatation?

Abstract

Objectives: There is evidence of a negative association between diabetes and both abdominal aortic aneurysm and aortic diameter. However, little information is available on the relation between diabetes and aortic root diameter. Methods: We studied 109 patients with type 2 diabetes. Two-dimensional echocardiography was used to measure the aortic root at the aortic annulus, the sinus of Valsalva, the sinotubular junction and the proximal part of the ascending aorta. Measured mean values were compared with 218 age- and sex-matched patients without diabetes. A comparison of the prevalence of aortic regurgitation between the 2 groups was also performed. Results: In patients with diabetes, the mean aortic root dimensions were significantly smaller than in nondiabetic patients (p < 0.05). The prevalence of aortic root dilatation was significantly higher in nondiabetic subjects than in patients with diabetes (9.63 vs. 2.75%; p = 0.025). In the multivariable regression model, diabetes was a significant negative determinant of aortic root size at all measured sites. The prevalence of aortic regurgitation tended to be higher in nondiabetic subjects than in diabetic participants (11 vs. 18.8%); however, the difference did not achieve statistical significance (p = 0.071). Conclusions: In patients with diabetes, the aortic root dimension is significantly smaller than in patients without diabetes.

Traditional Cardiovascular Risk Factors and Their Relation to Future Surgery for Valvular Heart Disease or Ascending Aortic Disease: A Case–Referent Study

“…Of note, a diagnosis of diabetes mellitus was related to reduced risk. In cross‐sectional studies, diseases of the ascending aorta have been inversely related to diabetes mellitus and associated with less systemic atherosclerosis, and an inverse association between aortic root diameter and diabetes mellitus has been demonstrated 31, 32. Furthermore, diabetes mellitus was less frequent among patients discharged for thoracic aortic aneurysms and dissections in a nation‐wide US study compared with controls 33.…”

Diabetes Mellitus and Aorta: Does Size Matter?

“…The teleological significance of the finding of Chen et al [5] , however, cannot be fully ascertained. A protective effect of diabetes mellitus on arterial dilatation is proposed by the authors [5] .…”

“…coronary ectasia [2] , or abdominal aortic aneurysm [3,4] . In the study by Chen et al [5] , which is published in this issue of Cardiology , combination of increased synthesis and reduced proteolysis, while collagen synthesis is also increased. Furthermore, diabetes mellitus is associated with the deposition of advanced glycation end-products, which form non-enzymatic crosslinks that involve collagen and elastin.…”

“…The authors [5] insightfully discuss the possible links with underlying pathology, mainly the alterations in the arterial wall matrix, as a result of metalloproteinase action, and the effect of advanced glycation end-products, based on findings of previous studies. In aneurysmal aortas there is evidence of up-regulated proteolytic activity and accelerated matrix depletion.…”

Sex-Specific Parameters of Ascending Aorta, Descending Aorta and Pulmonary Trunk by Computed Tomographic Angiography with Impact of Age, Hypertension, Smoking and Diabetes

“…In addition, diabetic patients found to have smaller aortic root parameters than in non-diabetics (Chen et al, 2009). In contrast, parameters of AA, DA and PT in the present study ron seleccionados entre enero del año 2009 a mayo del año 2011 por el Departamento de Radiología, Hospital de la Universidad de Jordania, Facultad de Medicina de la Universidad de Jordania, Amman, Jordania para una evaluación avanzada del DT y AT de la AA, AD y TP.…”