Elastic Modulus in Young Diabetic Patients (Ultrasound Measurements of Pulse Wave Velocity)

Stella, Andréa; Gessaroli, M.; Cifiello, B.I.; Salardi, S; Reggiani, A; Cacciari, E; D'Addato, M

doi:10.1177/000331978403501107

Cited by 18 publications

(10 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The bulk of the available PWV research in pediatric subjects includes those with diseases such as type 1 diabetes mellitus, 177,178 neurofibromatosis, 179,180 primary snoring, 181 Kawasaki disease, 182 polyarteritis nodosa, 183 and coarctation of the aorta after surgical repair. 184 -186 Most of these studies have control groups of varying mean ages (5 months to 22 years), with patient numbers ranging from 28 to 155 subjects.…”

Section: Data In Children and Adolescentsmentioning

confidence: 99%

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Urbina

Williams²,

Alpert³

et al. 2009

Hypertension

559

274

View full text Add to dashboard Cite

Abstract-Deterioration in endothelial function and arterial stiffness are early events in the development of cardiovascular diseases. In adults, noninvasive measures of atherosclerosis have become established as valid and reliable tools for refining cardiovascular risk to target individuals who need early intervention. With limited pediatric data, the use of these techniques in children and adolescents largely has been reserved for research purposes. Therefore, this scientific statement was written to (1) review the current literature on the noninvasive assessment of atherosclerosis in children and adolescents, (2) make recommendations for the standardization of these tools for research, and (3) stimulate further research with a goal of developing valid and reliable techniques with normative data for noninvasive clinical evaluation of atherosclerosis in pediatric patients. Precise and reliable noninvasive tests for atherosclerosis in youth will improve our ability to estimate future risk for heart attack and stroke. Currently, large longitudinal studies of cardiovascular risk factors in youth, such as the Bogalusa and Muscatine studies, lack sufficient adult subjects experiencing hard outcomes, such as heart attack and stroke, to produce meaningful risk scores like those developed from Framingham data.

show abstract

Section: Data In Children and Adolescentsmentioning

confidence: 99%

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Urbina

Williams²,

Alpert³

et al. 2009

Hypertension

559

274

View full text Add to dashboard Cite

show abstract

“…The literature consistently reports increased aortic stiffening with diabetes, 5,6 as well as less extreme alterations in glucose metabolism. 8,9,11 Our data support this finding, with glycosylated hemoglobin being a strong independent predictor of higher aPWV.…”

Section: Discussionmentioning

confidence: 93%

“…The cardiovascular risks associated with systolic hypertension are well documented. 3,4 Accelerated arterial stiffness has been linked to diabetes, 5,6 hyperglycemia, hyperinsulinemia, and impaired glucose tolerance. [7][8][9][10][11] These findings have been confirmed in older adults 12 and suggest that insulin resistance or its products, ie, hyperglycemia and hyperinsulinemia, may promote arterial stiffening independent of age.…”

mentioning

confidence: 99%

Aortic Stiffness Is Associated With Visceral Adiposity in Older Adults Enrolled in the Study of Health, Aging, and Body Composition

et al. 2001

View full text Add to dashboard Cite

Abstract-The central arteries stiffen with age, causing hemodynamic alterations that have been associated with cardiovascular events. Changes in body fat with age may be related to aortic stiffening. The association between vascular stiffness and body fat was evaluated in 2488 older adults (mean age, 74 years; 52% female; 40% black) enrolled in the Study of Health, Aging, and Body Composition (Health ABC), a prospective study of changes in weight and body composition. Clinical sites were located in Pittsburgh, Pa, and Memphis, Tenn. Aortic pulse wave velocity was used as an indirect measure of aortic stiffness. A faster pulse wave velocity indicates a stiffer aorta. Body fat measures were evaluated with dual energy x-ray absorptiometry and computed tomography. Independent of age and blood pressure, pulse wave velocity was positively associated with weight, abdominal circumference, abdominal subcutaneous fat, abdominal visceral fat, thigh fat area, and total fat (PϽ0.001 for all). The strongest association was with abdominal visceral fat. Elevated pulse wave velocity was also positively associated with history of diabetes and higher levels of glucose, insulin, and hemoglobin A1c (PϽ0.001 for all). In multivariate analysis, independent positive associations with pulse wave velocity were found for age, systolic blood pressure, heart rate, abdominal visceral fat, smoking, hemoglobin A1c, and history of hypertension. The association between pulse wave velocity and abdominal visceral fat was consistent across tertiles of body weight. Among older adults, higher levels of visceral fat are associated with greater aortic stiffness as measured by pulse wave velocity. Key Words: vascular stiffness Ⅲ central obesity Ⅲ aging Ⅲ insulin resistance Ⅲ pulse wave velocity A s we age, the arteries stiffen, resulting in higher systolic blood pressure (BP) and widening of the pulse pressure. Structural changes that occur with age include fragmentation and degeneration of elastin, increases in collagen, and thickening of the arterial wall. 1 A progressive dilation of the arteries accompanies this stiffening process. Arterial stiffening occurs at different rates for different individuals and can be viewed as a process of biological aging of the vascular system.Arterial stiffening can be evaluated indirectly by measurement of the speed of the systolic pressure wave as it travels down the aorta (ie, aortic pulse wave velocity [aPWV]). A faster PWV indicates a stiffer aorta. Elevated aPWV results in an early return of the reflected pressure wave from the periphery, causing amplification of the systolic pressure and a reduction in the diastolic pressure, 2 the hallmarks of isolated systolic hypertension. The cardiovascular risks associated with systolic hypertension are well documented. 3,4 Accelerated arterial stiffness has been linked to diabetes, 5,6 hyperglycemia, hyperinsulinemia, and impaired glucose tolerance. 7-11 These findings have been confirmed in older adults 12 and suggest that insulin resistance or its products, ie, hypergly...

show abstract

“…30 The findings presented here are consistent with this relationship and suggest that prevention of vascular stiffness will improve the health of older adults. The primary risk factors for vascular stiffness are hypertension [31][32][33][34] ; glucose abnormalities, including diabetes, 35,36 hyperglycemia, hyperinsulinemia, and impaired glucose tolerance [37][38][39] ; and increased body fat, specifically visceral adipose tissue. 12,40 In Health ABC participants, we have reported that all markers of central fat, including visceral and intermuscular and intramuscular fat, are associated with a higher PWV.…”

Section: Sutton-tyrrell Et Al Pwv Predicts CV Events In Older Adults mentioning

confidence: 99%

Elevated Aortic Pulse Wave Velocity, a Marker of Arterial Stiffness, Predicts Cardiovascular Events in Well-Functioning Older Adults

et al. 2005

View full text Add to dashboard Cite

MD; for the Health ABC StudyBackground-Aging results in vascular stiffening and an increase in the velocity of the pressure wave as it travels down the aorta. Increased aortic pulse wave velocity (aPWV) has been associated with mortality in clinical but not general populations. The objective of this investigation was to determine whether aPWV is associated with total and cardiovascular (CV) mortality and CV events in a community-dwelling sample of older adults. Methods and Results-aPWV was measured at baseline in 2488 participants from the Health, Aging and BodyComposition (Health ABC) study. Vital status, cause of death and coronary heart disease (CHD), stroke, and congestive heart failure were determined from medical records. Over 4.6 years, 265 deaths occurred, 111 as a result of cardiovascular causes. There were 341 CHD events, 94 stroke events, and 181 cases of congestive heart failure. Results are presented by quartiles because of a threshold effect between the first and second aPWV quartiles. Higher aPWV was associated with both total mortality (relative risk, 1.5, 1.6, and 1.7 for aPWV quartiles 2, 3, and 4 versus 1; Pϭ0.019) and cardiovascular mortality (relative risk, 2.1, 3.0, and 2.3 for quartiles 2, 3, and 4 versus 1; Pϭ0.004). aPWV quartile was also significantly associated with CHD (Pϭ0.007) and stroke (Pϭ0.001). These associations remained after adjustment for age, gender, race, systolic blood pressure, known CV disease, and other variables related to events. Conclusions-Among generally healthy, community-dwelling older adults, aPWV, a marker of arterial stiffness, is associated with higher CV mortality, CHD, and stroke.

show abstract

Elastic Modulus in Young Diabetic Patients (Ultrasound Measurements of Pulse Wave Velocity)

Cited by 18 publications

References 15 publications

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Aortic Stiffness Is Associated With Visceral Adiposity in Older Adults Enrolled in the Study of Health, Aging, and Body Composition

Elevated Aortic Pulse Wave Velocity, a Marker of Arterial Stiffness, Predicts Cardiovascular Events in Well-Functioning Older Adults

Contact Info

Product

Resources

About