Increased aortic stiffness index in patients with type 1 diabetes without cardiovascular disease compared to controls

Zoppini, Giacomo; Bergamini, Corinna; Trombetta, Maddalena; Sabbagh, Lara; Dauriz, Marco; Mantovani, Alessandro; Targher, Giovanni; Fossà, Irene; Rinaldi, Elisabetta; Bonora, Enzo

doi:10.1007/s40618-019-01032-7

Cited by 6 publications

(3 citation statements)

References 33 publications

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“…taking into account also other deleterious processes that contribute to increased CV risk such as low-grade inflammation or oxidative stress [12]. Arterial stiffness was found to be increased in patients with T1D compared to healthy age-matched controls independent of traditional CV risk factors [18][19][20][21]. More importantly, carotid-femoral pulse wave velocity (cf-PWV)-the gold-standard measure for arterial stiffness [22]-showed important independent prognostic value in the development of CVD and mortality in both healthy and diseased populations [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools

Helleputte

Bortel

Verbeke

et al. 2022

Cardiovasc Diabetol

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Background Arterial stiffness is a potential biomarker for cardiovascular disease (CVD) risk in patients with type 1 diabetes (T1D). However, its relation with other CV risk evaluation tools in T1D has not been elucidated yet. This study aimed to evaluate arterial stiffness in T1D patients free from known CVD, and compare it to other CV risk evaluation tools used in T1D. Methods Cross-sectional study in adults with a T1D duration of at least 10 years and without established CVD. Patients were categorized in CVD risk groups based on 2019 European Society of Cardiology (ESC) guidelines, and the STENO T1D risk engine was used to estimate 10-year risk for CV events. Arterial stiffness was evaluated with carotid-femoral pulse wave velocity (cf-PWV). Coronary artery calcium (CAC) score was assessed and carotid ultrasound was performed. Ambulatory 24-h blood pressure and central hemodynamic parameters were evaluated. Data on renal function and diabetic kidney disease was retrieved. Results 54 patients (age: 46 ± 9.5 years; T1D duration: 27 ± 8.8 years) were included. One-fourth of patients showed prematurely increased aortic stiffness based on cf-PWV (24%). Cf-PWV was significantly associated with CAC score, carotid intima-media thickness, central hemodynamic parameters and diabetic kidney disease. Based on STENO, 20 patients (37%) were at low, 20 patients (37%) at moderate, and 14 patients (26%) at high 10-year risk for CV event. Cf-PWV was strongly associated with the STENO score (rs = + 0.81; R2 = 0.566, p < 0.001), increasing with each higher STENO group (p < 0.01). However, cf-PWV was not significantly different between the two CV risk groups (high versus very high) based on ESC criteria, and ESC criteria compared to STENO classified 10 patients more as having > 10% 10-year risk for CV events (n = 44/54; 81.5% versus n = 34/54; 63%). Conclusions This study demonstrated that a substantial proportion of long-standing T1D patients free from known CVD show premature arterial stiffening. Cf-PWV strongly associates with the STENO risk score for future CV events and with cardiovascular imaging and function outcomes, thereby illustrating the clinical importance of arterial stiffness. The data, however, also show considerable heterogeneity in CV risk and differences in risk categorisation between the STENO tool and ESC criteria.There is a need for refinement of CV risk classification in T1D, and future studies should investigate if evaluation of arterial stiffness should be implemented in T1D clinical practice and which patients benefit the most from its assessment.

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Section: Introductionmentioning

confidence: 99%

Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools

Helleputte

Bortel

Verbeke

et al. 2022

Cardiovasc Diabetol

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“…However, there is no data probing the relation of microalbuminuria and elastic properties of the aortic root. Proximal aorta with a normal elasticity has a protective function and may store 50% of the systolic left ventricular stroke volume 37. An impaired aortic elasticity may be associated with the progression of microvascular and macrovascular complications of diabetes.…”

Section: Discussionmentioning

confidence: 99%

<p>Aortic Stiffness Index And Carotid Intima-Media Thickness Are Independently Associated With The Presence Of Microalbuminuria In Patients With Type 2 Diabetes Mellitus</p>

Turan

2019

DMSO

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PurposeMicroalbuminuria is a premature and widely used indicator of diabetic nephropathy and is reported to be related with a higher cardiovascular risk in diabetic patients. We aimed to examine whether the echocardiographic parameters, such as epicardial fat thickness (EFT), carotid intima-media thickness (CIMT) and aortic stiffness index (ASI) are associated with microalbuminuria in patients with diabetes mellitus type 2 (T2DM).Patients and methodsA total of 272 consecutive patients were enrolled and after the exclusion criteria, the data of 180 patients with T2DM were used in this cross-sectional study. Patients were divided into two groups: 82 patients with microalbuminuria and 98 patients without microalbuminuria (normoalbuminuria). The laboratory results and echocardiographic EFT, CIMT and ASI parameters were noted.ResultsCompared with the normoalbuminuria group, EFT, CIMT and ASI were significantly higher in the microalbuminuria group (p<0.05 for all). In logistic regression analysis; CIMT (OR: 3.15, p=0.024) and ASI (OR: 4.19, p=0.016) were independently associated with microalbuminuria in patients with T2DM.ConclusionIn addition to CIMT, as a novel finding, ASI which is an indicator for the elastic properties of the aortic root was independently associated with microalbuminuria. CIMT and ASI measurement by echocardiography may be helpful in identifying the accompanying factors in the development of nephropathy.

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“…The study was carried out on 93 consecutive outpatients with type 1 diabetes (mean age 32.8 ± 9.8 years) attending our clinic as previously described [6]. Type 1 diabetes was the inclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

Echocardiographic parameters according to insulin dose in young patients affected by type 1 diabetes

et al. 2020

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Insulin dose has been found to associate to several cardiometabolic risk factors in type 1 diabetes. Changes over time in body weight and composition may partly explain this association. However, no data are available on the relationship between insulin dose and echocardiographic parameters of both systolic and diastolic function in type 1 diabetes. Therefore, the aim of the present study was to examine systolic and diastolic echocardiographic parameters in relation to insulin dose in young patients with type 1 diabetes. The study was carried out on 93 consecutive outpatients with type 1 diabetes with a mean age of 32.8 ± 9.8 years. All patients were examined with a transthoracic echocardiography. Clinical and laboratory data were collected. The median value of daily insulin dose was used to categorized patients in two groups: high and low insulin dose group. Patients belonging to the high insulin dose group showed higher levels of cardiometabolic risk factors such as BMI, triglycerides and TG/HDL cholesterol ratio. Indexes of both systolic and diastolic function were similar in both groups except isovolumetric relaxation time (IVRT), that was significantly prolonged in patients of the high insulin group (94.4 ± 15.0 vs 86.7 ± 13.1 ms, p = 0.008). In the multivariate regression analysis, insulin dose was positively and significantly associated with IVRT. In this study we report an association between insulin dose and impaired active diastolic myocardial relaxation. Future studies are needed to further explore this observation.

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Increased aortic stiffness index in patients with type 1 diabetes without cardiovascular disease compared to controls

Cited by 6 publications

References 33 publications

Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools

Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools

<p>Aortic Stiffness Index And Carotid Intima-Media Thickness Are Independently Associated With The Presence Of Microalbuminuria In Patients With Type 2 Diabetes Mellitus</p>

Echocardiographic parameters according to insulin dose in young patients affected by type 1 diabetes

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