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Relationship between left ventricular diastolic function and arterial stiffness in asymptomatic patients with diabetes mellitus

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Abstract

Left ventricular (LV) diastolic dysfunction and increased arterial stiffness are common in patients with diabetes mellitus (DM). However, the relation between these two pathophysiological factors remains unclear. The aim of this study was to investigate the relationship between LV diastolic function and arterial stiffness as assessed with applanation tonometry. In 142 asymptomatic patients with DM (mean age 48 years, 75 (53 %) men, 72 (51 %) patients with type 2 DM) LV diastolic function was assessed with echocardiography. Arterial stiffness was evaluated measuring the aortic pulse wave velocity (PWV) whereas wave reflection was assessed measuring central systolic blood pressure (cSBP), central pulse pressure (cPP), and augmentation index (AIx) with applanation tonometry. Mean E/A ratio, E′ and E/E′ ratio were 1.1 ± 0.3, 8.1 ± 2.3 and 9.2 ± 3.3 cm/s, respectively. Mean PWV, mean cSBP, median cPP and mean AIx were 7.9 ± 2.4 m/s, 122 ± 17 mmHg, 40 [35–51] mmHg and 17.9 ± 12.1 %, respectively. PWV was independently associated with LV diastolic dysfunction grade (β = 0.76, p = 0.03). In contrast, measures of wave reflection, cPP, cSBP and AIx were independently related with E/A ratio, but not with the LV diastolic dysfunction grade. Parameters of arterial stiffness and wave reflection are associated with echocardiographic indices of LV diastolic function in asymptomatic patients with DM. Therapies that prevent progression of arterial stiffness and reduce late-systolic pressure overload may help to reduce the prevalence of LV diastolic dysfunction in this population.

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Acknowledgments

The department of Cardiology received research grants from Biotronik (Berlin, Germany), BMS Medical Imaging (North Billerica, Massachusetts), Boston Scientific (Natick, Massachusetts), Edwards Lifesciences (Irvine, California), GE Healthcare (Buckinghamshire, United Kingdom), Medtronic (Minneapolis, Minnesota) and St. Jude Medical (St. Paul, Minnesota). V. Delgado received consulting fees from St. Jude Medical. J. Wouter Jukema received research grants from and was speaker on (CME accredited) meetings sponsored by Astellas, Astra-Zeneca, Biotronik, Boston Scientific, Daiichi Sankyo, Lilly, Genzyme, Medtronic, Merck-Schering-Plough, Pfizer, Orbus Neich, Novartis, Roche, Servier, Sanofi Aventis, the Netherlands Heart Foundation, the Interuniversity Cardiology Institute of the Netherlands and the European Community Framework KP7 Programme.

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Authors and Affiliations

  1. Department of cardiology, C5-P, Leiden University Medical Center, Postbus 9600, 2300 RC, Leiden, The Netherlands

    Cornelis J. Roos, Dominique Auger, Roxana Djaberi, Jeroen J. Bax, Victoria Delgado, J. Wouter Jukema & Arthur J. Scholte

  2. Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands

    Cornelis J. Roos, Jeroen J. Bax & J. Wouter Jukema

  3. Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands

    Eelco J. de Koning & Ton J. Rabelink

  4. Department of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands

    Alberto M. Pereira

  5. Einthoven Laboratory of Experimental Vascular Medicine the Netherlands, Leiden, The Netherlands

    J. Wouter Jukema

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  1. Cornelis J. Roos
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  2. Dominique Auger
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  3. Roxana Djaberi
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  4. Eelco J. de Koning
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  7. Jeroen J. Bax
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  8. Victoria Delgado
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  9. J. Wouter Jukema
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  10. Arthur J. Scholte
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Correspondence to Cornelis J. Roos.

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Roos, C.J., Auger, D., Djaberi, R. et al. Relationship between left ventricular diastolic function and arterial stiffness in asymptomatic patients with diabetes mellitus. Int J Cardiovasc Imaging 29, 609–616 (2013). https://doi.org/10.1007/s10554-012-0129-y

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  • DOI: https://doi.org/10.1007/s10554-012-0129-y

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