Improvement of cardio-ankle vascular index by glimepiride in type 2 diabetic patients

Nagayama, Daiji; Saiki, Atsuhito; Endo, Kei; Yamaguchi, Takashi; Ban, Noriko; Kawana, Hidetoshi; Ohira, Masahiro; Oyama, Tomokazu; Miyashita, Yoh; Shirai, Kohji

doi:10.1111/j.1742-1241.2010.02399.x

Cited by 70 publications

(63 citation statements)

References 33 publications

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“…It is well known that some medications and factors influence arterial stiffness. [21][22][23][24][25][26][27][28] The possibility that different pharmacological therapies have different effects on this relationship cannot be excluded. Although a patient population of 30 may be relatively small, this study used a longitudinal method.…”

Section: Discussionmentioning

confidence: 99%

Cardio-Ankle Vascular Index Relates to Left Ventricular Ejection Fraction in Patients With Heart Failure

Zhang¹,

Ohira

Iizuka

et al. 2013

Int. Heart J.

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SummaryThe cardio-ankle vascular index (CAVI) has been proposed as a new noninvasive marker of arterial stiffness independent of blood pressure. Arterial stiffness is closely related to afterload, and elevated afterload aggravates heart failure. We hypothesized that CAVI is a potential marker of afterload in patients with heart failure. Thirty patients who were admitted because of acute heart failure were identified retrospectively from a review of clinical records. Plasma brain natriuretic peptide (BNP) levels, CAVI, cardiothoracic ratio (CTR), and echocardiographic parameters obtained during acute and chronic phases of heart failure were analyzed. Left ventricular ejection fraction (LVEF) increased significantly and CTR, BNP and CAVI decreased significantly after treatment of heart failure. A significant negative correlation was observed between the change in CAVI and change in LVEF in all subjects (r = -0.3272, P < 0.05). To examine the relationship between CAVI and LVEF, we divided the patients into two subgroups (∆CAVI < -0.5; CAVI decrease group, ∆CAVI ≥ -0.5; CAVI non-decrease group). CAVI was significantly improved after heart failure treatment only in the CAVI decrease group. LVEF decreased significantly in both groups, but the P value was smaller in the CAVI decrease group than in the CAVI non-decrease group. The change in LVEF correlated significantly with the change in CAVI in the CAVI decrease group (r = -0.4201, P < 0.05), whereas no significant correlation was found in the CAVI non-decrease group. CAVI correlates inversely with LVEF after heart failure treatment. Our results suggest that CAVI might partially reflect the afterload in patients with heart failure. (Int Heart J 2013; 54: 216-221) Key words: Left ventricle ejection fraction, Afterload H eart failure is the inability of the heart to supply adequate blood flow and therefore oxygen to peripheral tissues and organs. It is estimated that there are more than 15 million new cases of heart failure each year worldwide. The overall prevalence of heart failure is increasing because of aging of the population. 1) Heart failure is the leading cause of hospitalization of patients over 65 years of age. Despite many new advances in drug therapy and cardiac assist devices, the prognosis for chronic heart failure remains very poor.Cardiac dysfunction induces changes in vascular function, cardiac output, and neurohumoral status. These changes serve as compensatory mechanisms to help maintain cardiac output (primarily by the Frank-Starling mechanism) and arterial blood pressure (by systemic vasoconstriction). However, these compensatory changes over months and years can worsen cardiac function. This compensation is at the expense of an increase in systemic vascular resistance that increases the afterload on the left ventricle, which can further depress its output. An increase in afterload shifts the Frank-Starling curve downward and to the right. The increased afterload reduces the velocity of fiber shortening. Because the period of time available for ...

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Section: Discussionmentioning

confidence: 99%

Cardio-Ankle Vascular Index Relates to Left Ventricular Ejection Fraction in Patients With Heart Failure

Zhang¹,

Ohira

Iizuka

et al. 2013

Int. Heart J.

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“…23) In addition, we have reported that improved insulin sensitivity may contribute to the decrease in CAVI. 20,24) In the present study, the change in serum LPL mass was a significant independent predictor of change in CAVI. This result may suggest that sarpogrelate improves arterial stiffness through mitigating insulin sensitivity.…”

Section: Discussionmentioning

confidence: 68%

“…[16][17][18] We have reported that a low serum LPL mass level may be a useful indicator of insulin resistance. [19][20][21][22] On the other hand, sarpogrelate is speculated to have an insulin-sensitizing effect through modifying adiponectin 4) and reducing epinephrine release. 23) In addition, we have reported that improved insulin sensitivity may contribute to the decrease in CAVI.…”

Section: Discussionmentioning

confidence: 99%

Sarpogrelate Hydrochloride Decreases Cardio-Ankle Vascular Index Accompanied by Increased Serum Lipoprotein Lipase Mass in Type 2 Diabetic Patients

et al. 2014

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SummaryThe 5-hydroxytryptamine2A receptor antagonist sarpogrelate hydrochloride exerts its effect not only by inhibition of platelet aggregation, but also by some pleiotropic effects. We have reported that a low serum lipoprotein lipase (LPL) mass level reflects insulin resistance and may be a risk factor for atherosclerotic diseases. The aim of this prospective study was to clarify the effect of sarpogrelate on serum LPL mass and cardio-ankle vascular index (CAVI) as a marker related to arterial stiffness.Thirty-five type 2 diabetic patients (21 males and 14 females) with ankle brachial indices higher than 0.90 received sarpogrelate hydrochloride 300 mg/day for 6 months. Serum LPL mass and CAVI were measured during the study.After 6 months of sarpogrelate hydrochloride treatment, CAVI decreased significantly (10.11 ± 0.92 to 9.87 ± 0.97, P < 0.05) and serum LPL mass increased significantly (58.2 ± 17.5 to 63.5 ± 21.4, P < 0.05). A negative correlation between change in CAVI and change in serum LPL mass was observed (r = -0.34, P < 0.05). Multiple regression analysis identified a change in serum LPL mass as a significant independent predictor for change in CAVI.We demonstrated that sarpogrelate hydrochloride decreased CAVI accompanied by increased serum LPL mass in type 2 diabetic patients. This result suggests that sarpogrelate hydrochloride improves arterial stiffness and is a potential treatment for diabetic angiopathy. (Int Heart J 2014; 55: 337-341) Key words: Diabetic angiopathy 5 -Hydroxytryptamine (5-HT) is closely related to the pathogenesis of diabetic angiopathy. Sarpogrelate hydrochloride (sarpogrelate), a selective 5-HT2A receptor antagonist, is used in diabetic patients with chronic arterial occlusive diseases.1) Sarpogrelate suppresses platelet aggregation, vascular endothelial dysfunction, and smooth muscle contraction mediated by 5-HT2A receptors.2,3) Furthermore, the effect of sarpogrelate on modification of adipocyte structure and function has been reported. 4)Recently, cardio-ankle vascular index (CAVI) has been developed as a marker related to arterial stiffness in Japan, which essentially reflects the stiffness of the aorta, femoral artery, and tibial artery. The CAVI is independent of blood pressure (BP) and has adequate reproducibility for clinical use. 5)Furthermore, no special technique is required for the measurement of CAVI. Several reports have demonstrated the usefulness of CAVI for the detection of atherosclerotic diseases. [5][6][7][8][9] However, the effect of sarpogrelate on CAVI is not clear.In this study, we investigated prospectively the effect of sarpogrelate on arterial stiffness assessed by CAVI in type 2 diabetic patients. Furthermore, factors contributing to the change in arterial stiffness were also analyzed.

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“…Однако нельзя исключить возможное влияние ещё неизученных эффектов ситаглиптина, связанных с увеличением уровня глюкагоноподобного пеп-тида-1 (ГПП-1). Уменьшение жёсткости плечевой артерии может быть связано со снижением инсули-норезистентности, уменьшением активности окис-лительного стресса, процессов воспаления и фиброза на фоне компенсации диабета [17][18][19]. Как известно, ситаглиптин, а также саксаглиптин и вилдаглиптин улучшают функцию эндотелия благодаря восстанов-лению биодоступности NO [20,21], что может вно-сить позитивный вклад в изменение функциональ-ного компонента формирования жёсткости артерий, особенно мышечного типа.…”

Section: российский кардиологический журнал № 3 (119) | 2015unclassified

Assessment of Sitagliptin Influence on Arterial Wall Stiffness, Renal Function and Renal Circulation in Cardiovscular Patients With Decompensated Type 2 Diabetes

Oskola¹,

Шубина²,

Zairova³

et al. 2015

Ross. kardiol. ž.

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Цель. изучить динамику показателей жёсткости артерий различных типов, функции почек и почечного кровотока у больных гипертонической болезнью (гб) и ишемической болезнью сердца (ибс) с декомпенсированным сахарным диабетом 2 типа (сд-2) на фоне терапии ситаглиптином в течение 24 недель. Материал и методы. В исследование было включено 30 пациентов с деком-пенсированным сд-2 (hbA 1c >7%) и гб, большая часть из которых имели ибс. Оценивали динамику показателей углеводного и липидного обменов, показа-телей жёсткости артерий различных структурно-функциональных типов, функ-ции почек и почечного кровотока на фоне терапии ситаглиптином в течение 24 недель. Результаты. динамики по показателям жёсткости артерий различных струк-турно-функциональных типов, функции почек и почечного кровотока среди всех больных из группы терапии ситаглиптином (n=15) и группы сравнения (n=15) не выявлено. Однако, у больных, достигших компенсации сд-2 на фоне приёма ситаглиптина (n=8), отмечено уменьшение индекса жёсткости β пле-чевой артерии (мышечный тип) на 37% от исходного уровня (p<0,01). дина-мики по показателям жёсткости артерий мышечно-эластического и мышеч-ного типов не обнаружено. Заключение. У больных гипертонической болезнью и ишемической болез-нью сердца с сд-2 на фоне сахароснижающей терапии динамики по показа-телям жёсткости аорты, общей сонной артерии и показателям почечного кровотока в течение 6 мес. наблюдения отмечено не было. Однако на фоне сахароснижающей терапии с применением ингибитора дипептидилпепти-дазы-4 (ситаглиптина) в течение 6 мес. при условии достижения компенса-ции сд-2 (hbA 1c <7%), наблюдалось уменьшение жёсткости плечевой арте-рии (мышечный тип). Аг -артериальная гипертония, Ад -артериальное давление, бРА -блока-торы ангиотензиновых рецепторов, гб -гипертоническая болезнь, гПП-1 -глюкагоноподобный пептид-1, дПП-4 -дипептидилпептидаза-4, ибс -ише-мическая болезнь сердца, иАПф -ингибиторы ангиотензинпревращающего фермента, ЛПВП -липопротеиды высокой плотности, ЛПНП -липопротеиды низкой плотности, МАУ -микроальбуминурия, ОсА -общая сонная артерия, ПлА -плечевая артерия, Пи -пульсационный индекс, ПсМ -препараты сульфонилмочевины, Ри -индекс резистивности, сд-2 -сахарный диабет 2 типа, сПВкф -скорость пульсовой волны на каротидно-феморальном сег-менте, ссЗ -сердечно-сосудистые заболевания, ссО -сердечно-сосудис-тые осложнения, ссТ -сахароснижающая терапия, ХбП -хроническая ASSESSMENT OF SITAGLIPTIN INFLUENCE ON ARTERIAL WALL STIFFNESS, RENAL FUNCTION AND RENAL CIRCULATION IN CARDIOVSCULAR PATIENTS WITH DECOMPENSATED TYPE 2 DIABETESOskola E. V., shubina A. t., Zairova A. R., Andreevskaya M. V., Bogieva R. M., Bolotina M. g., Rogoza A. n., Karpov yu. A.Aim. to study dynamics of stiffness parameters in various type arteries, renal function and renal circulation in arterial hypertension (Ah) and ischemic heart disease (Chd) with decompensated 2 type diabetes mellitus (dM2) on the sitagliptin therapy during 24 weeks. Material and methods. totally 30 patients included, with decompensated dM2 (hbA 1c >7%) and Ah, most ha...

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Improvement of cardio-ankle vascular index by glimepiride in type 2 diabetic patients

Abstract: These results suggest that glimepiride improves CAVI compared with glibenclamide. Reduced oxidative stress and improved insulin resistance may contribute to the improvement of CAVI by glimerpiride.

Cited by 70 publications

References 33 publications

Cardio-Ankle Vascular Index Relates to Left Ventricular Ejection Fraction in Patients With Heart Failure

Cardio-Ankle Vascular Index Relates to Left Ventricular Ejection Fraction in Patients With Heart Failure

Sarpogrelate Hydrochloride Decreases Cardio-Ankle Vascular Index Accompanied by Increased Serum Lipoprotein Lipase Mass in Type 2 Diabetic Patients

Assessment of Sitagliptin Influence on Arterial Wall Stiffness, Renal Function and Renal Circulation in Cardiovscular Patients With Decompensated Type 2 Diabetes

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