Increased high-risk coronary plaque burden is associated with arterial stiffness in patients with type 2 diabetes without clinical signs of coronary artery disease

Funck, Kristian Løkke; Laugesen, Esben; Øvrehus, Kristian Altern; Jensen, Jesper Møller; Nørgaard, Bjarne Linde; Dey, Damini; Hansen, Troels Krarup; Poulsen, Per L.

doi:10.1097/hjh.0000000000001308

Cited by 20 publications

(23 citation statements)

References 41 publications

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“…Proportional increases in PWV values with the severity of CAC score have also been reported . Furthermore, PWV was correlated with the presence and progression of stenosis or plaque development in the coronary arteries according to findings from CCTA in asymptomatic DM patients . Similarly, in asymptomatic individuals, PWV was identified as an independent prognostic factor for the presence of CAD diagnosed by CCTA .…”

Section: Discussionmentioning

confidence: 76%

“…33 Furthermore, PWV was correlated with the presence and progression of stenosis or plaque development in the coronary arteries according to findings from CCTA in asymptomatic DM patients. 14,34 Similarly, in asymptomatic individuals, PWV was identified as an independent prognostic factor for the presence of CAD diagnosed by CCTA. 15,35,36 In symptomatic patients, PWV levels were positively related to the presence and severity of CAD as assessed by invasive coronary angiography.…”

Section: Discussionmentioning

confidence: 91%

“…8,13 In asymptomatic CAD patients, higher PWV values were also associated with the progression of coronary atherosclerosis assessed by either coronary artery calcium (CAC) score or luminal stenosis on computed tomography coronary angiography (CCTA). [13][14][15] Moreover, severe CAD has been associated with presence of abdominal aneurysms. 16 However, the association between increased PWV and presence of CAD in patients with abdominal aneurysms has not been investigated.…”

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confidence: 99%

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Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms

Rafouli‐Stergiou

Ikonomidis

Katsiki

et al. 2020

J of Clinical Hypertension

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Pulse wave velocity (PWV) is a valid, clinically feasible marker of arterial stiffening, and a strong predictor of outcomes. The present study aimed to compare aortic elastic properties in patients with abdominal aortic aneurysms (AAA), with or without coronary artery disease (CAD), as well as healthy individuals. A total of 130 patients with AAA, eligible for interventional repair, and 30 healthy individuals, comprising the control group (HC), were enrolled. Presence of CAD was identified by coronary angiography. Aortic PWV (aPWV) was measured using the Arteriograph. aPWV was found considerably higher in AAA patients compared with HC group (11.5 ± 2.9 vs 7.3 ± 1.6 m/s, P < .001). Importantly, among patients with AAA, those with concomitant CAD (n = 41) had greater aPWV than those without CAD (12.5 ± 2.9 vs 11.0 ± 3.0 m/s, P = .03). In receiver operator curve (ROC) analysis, a value of aPWV above 12.8 m/s was identified to correlate with the presence of CAD in the AAA patient population. After adjustment for confounders, including hypertension which is one of the major risk factors for abdominal aneurysms, multivariate logistic regression analysis revealed that this aPWV cutoff remained independently associated with presence of CAD [odds ratio = 1.64, 95% confidence interval =1.19‐4.08, P = .03]. The coexistence of CAD and AAA is characterized by a greater arterial stiffness. This finding should be taken into consideration when selecting endovascular stents with more favorable elastic properties. Moreover, AAA patients with high aPWV (>12.8 m/s) are more likely to also have CAD, and this may be considered by vascular surgeons when evaluating patients' cardiovascular risk.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

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Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms

Rafouli‐Stergiou

Ikonomidis

Katsiki

et al. 2020

J of Clinical Hypertension

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“…Patients with a high EATV have an elevated risk of coronary events and may need both lipid-lowering therapy and strict dietary manage-ment. 23) It is well known that EATV shows an association with the severity of coronary artery disease and with potentially unstable atherosclerotic plaque rather than stable plaque (fibrous plaque). 17,18,[20][21][22]24,25) Betteencourt, et al 14) and Gitsioudis, et al 15) previously found a positive correlation between EAT and the coronary plaque burden by using coronary CT.…”

Section: Discussionmentioning

confidence: 99%

Association of Epicardial Adipose Tissue Volume and Total Coronary Plaque Burden in Patients with Coronary Artery Disease

et al. 2018

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The relationship between epicardial adipose tissue volume (EATV) and plaque vulnerability in non-culprit coronary lesions is not clearly understood. Fifty-four consecutive patients/158 lesions with suspected coronary artery disease underwent computed tomography (CT) and 40 MHz intravascular ultrasound imaging (iMap-IVUS) in cardiac catheterization. Crosssectional CT slices were semiautomatically traced from base to apex of the heart. Using a 3D workstation, EATV was measured as the sum of fat areas (−190 to −30 Hounsfield units [HU]). All coronary vessels were imaged using iMap-IVUS before stenting to analyze coronary plaques as fibrotic, lipidic, necrotic, or calcified tissue. Mean EATV was 73.7 ± 24.6 (range: 30.2 to 131.8) mL. Patients were divided into two groups by mean EATV (group H: n = 27, EATV !73.7 mL; group L: n = 27, EATV < 73.7 mL). Total luminal volume, total vessel volume, and total plaque volume were significantly larger in group H. Fibrotic plaque and lipidic plaque volumes were also significantly larger in group H. There was a significant negative correlation between EATV and fibrous tissue (r =-0.31, P = 0.02) and a significant positive correlation between EATV and necrotic tissue (r = 0.37, P = 0.007). EATV was related to plaque with vulnerability in the right coronary artery (RCA) (r = 0.57, P = 0.04) and the left anterior descending artery (LAD) (r = 0.53, P = 0.02). In conclusion, increased EATV was associated with the total coronary plaque burden and composition, particularly in the RCA and LAD.

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“…Arterial stiffening is a feature of physiological vascular aging that is accelerated in type 2 diabetes and a variety of pathological conditions associated with increased cardiovascular risk [6] . Coronary plaques are more prevalent in well controlled asymptomatic patients with type 2 diabetes compared with healthy controls and independently associated with arterial stiffness [7] . The prevention of arterial stiffness therefore plays an important role in the management of type 2 diabetes.…”

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confidence: 99%

Low-frequency and low-intensity ultrasound irradiation to the forearm improves an index of arterial stiffness in subjects with type 2 diabetes and hypertension

Nonogaki

Murakami

Yamazaki

et al. 2017

IJC Heart & Vasculature

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ObjectivesThe arterial pressure-volume index (API) is a non-invasive assessment of arterial stiffness, and is suggested as a useful predictor of future cardiovascular events. The aim of the present study was to determine the effects of low-frequency and low-intensity ultrasound applied to the forearm for 10 min on the API in Japanese subjects with type 2 diabetes and hypertension.MethodsWe examined the effects of low-frequency and low-intensity ultrasound (800 kHz, 25 mW/cm2) applied to the forearm for 10 min on the API, blood pressure (BP) and pulse rate in 40 Japanese subjects (13 men and 27 women; mean age ± SE, 70 ± 2 years) with type 2 diabetes and hypertension, who had the API > 30 and systolic BP > 140 mmHg at a clinic visit. We also examined the effects of the ultrasound irradiation for 10 min on the API, BP and pulse rate in 33 Japanese subjects (11 men and 22 women; mean age ± SE, 65 ± 2 years) with type 2 diabetes and hypertension, who had the API > 30 and systolic BP (SBP) < 140 mmHg.ResultsThe API, systolic BP and pulse rate in the ultrasound treatment group was significantly lower than the baseline values in the subjects who had the API > 30 and either the baseline of systolic BP > 140 mmHg or systolic BP < 140 mmHg.ConclusionsThe low-frequency and low-intensity ultrasound irradiation to the forearm for 10 min might be useful as a preventive application for arterial stiffness in subjects with type 2 diabetes and hypertension.

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Increased high-risk coronary plaque burden is associated with arterial stiffness in patients with type 2 diabetes without clinical signs of coronary artery disease

Abstract: Coronary plaques with unfavorable characteristics are more prevalent in well controlled asymptomatic patients with type 2 diabetes compared with healthy controls and independently associated with arterial stiffness.Clinical trials registration number: NCT02001532.

Cited by 20 publications

References 41 publications

Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms

Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms

Association of Epicardial Adipose Tissue Volume and Total Coronary Plaque Burden in Patients with Coronary Artery Disease

Low-frequency and low-intensity ultrasound irradiation to the forearm improves an index of arterial stiffness in subjects with type 2 diabetes and hypertension

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