Improvement of postprandial hyperglycemia and arterial stiffness upon switching from premixed human insulin 30/70 to biphasic insulin aspart 30/70

Ohira, Masahiro; Endo, Kei; Oyama, Tomokazu; Yamaguchi, Takashi; Ban, Noriko; Kawana, Hidetoshi; Nagayama, Daiji; Nagumo, Ayako; Saiki, Atsuhito; Murano, Takeyoshi; Watanabe, Hitoshi; Miyashita, Yoh; Shirai, Kohji

doi:10.1016/j.metabol.2010.06.001

Cited by 46 publications

(44 citation statements)

References 52 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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“…Nagayama et al 51) reported that glimepiride decreases CAVI accompanied by an improved glucose level. Ohira et al 52) reported that insulin injection also decreases CAVI concomitant with a decrease in the blood glucose level. These clinical observations may suggest that CAVI is a sensitive physiological index for monitoring the stress on the arterial wall by high blood glucose, probably due to glucose toxication.…”

Section: B Diabetes Mellitusmentioning

confidence: 99%

Cardio-Ankle Vascular Index (CAVI) as a Novel Indicator of Arterial Stiffness: Theory, Evidence and Perspectives

Shirai

Hiruta

Song

et al. 2011

J Atheroscler Thromb

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426

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The cardio-ankle vascular index (CAVI) is a new index of the overall stiffness of the artery from the origin of the aorta to the ankle. The most conspicuous feature of CAVI is its independence of blood pressure at the time of measurement. CAVI increases with age and in many arteriosclerotic diseases, such as coronary artery disease, carotid arteriosclerosis, chronic kidney disease and cerebrovascular disease, and is related to many coronary risk factors, such as hypertension, diabetes mellitus, dyslipidemia and smoking. Furthermore, CAVI decreases by controlling diabetes mellitus and hypertension, and also by abstaining from smoking. This suggests that CAVI is a physiological surrogate marker of athero-or arteriosclerosis, and also might be an indicator of lifestyle modification. Recently, it has been reported that CAVI and several left ventricular functions are co-related, suggesting a connection between the heart muscle and vascular function. This review covers the principles of CAVI and our current knowledge about CAVI, focusing on its roles and future outlook. J Atheroscler Thromb, 2011; 18:924-938.

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“…Alpha-glucosidase inhibitor, acarbose, reduces CAVI mediated by an improvement of postprandial hyperglycemia 66) . Ohira et al 67) reported that switching biphasic insulin from human insulin 30/70 to insulin aspart 30/70 improved CAVI together with the marker of postprandial hyperglycemia.…”

Section: Treatment Of Diabetes Mellitusmentioning

confidence: 99%

The Role of a Novel Arterial Stiffness Parameter, Cardio-Ankle Vascular Index (CAVI), as a Surrogate Marker for Cardiovascular Diseases

Saiki

Sato

Watanabe

et al. 2016

J Atheroscler Thromb

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Measurement of arterial stiffness in routine medical practice is important to assess the progression of arteriosclerosis. So far, many parameters have been proposed to quantitatively represent arterial stiffness. Among these, pulse wave velocity (PWV) has been most frequently applied to clinical medicine because those could be measured simply and non-invasively. PWV had established the usefulness of measuring arterial wall stiffness. However, PWV essentially depends on blood pressure at the time of measurement. Therefore, PWV is not appropriate as a parameter for the evaluation of arterial stiffness, particularly for the studies involving blood pressure changes.On the other hand, stiffness parameter is an index reflecting arterial stiffness without the influence of blood pressure. Recently, this parameter has been applied to develop a new arterial stiffness index called cardio-ankle vascular index (CAVI). Therefore, CAVI does not depend on blood pressure changes during the measurements; CAVI could represent the stiffness of the arterial tree from the origin of the aorta to the ankle.Many clinical studies obtained from CAVI are being accumulated. CAVI showed high value in arteriosclerotic diseases, such as coronary artery diseases, cerebral infarction, and chronic kidney diseases, and also in majority of people with various coronary risk factors. The improvement of those risk factors decreased CAVI. Furthermore, the role of CAVI as a predictor of cardio-vascular events was reported recently.We review the clinical studies on CAVI and discuss the clinical usefulness of CAVI as a candidate surrogate end-point marker for cardiovascular disease.

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Improvement of postprandial hyperglycemia and arterial stiffness upon switching from premixed human insulin 30/70 to biphasic insulin aspart 30/70

Cited by 46 publications

References 52 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

Cardio-Ankle Vascular Index (CAVI) as a Novel Indicator of Arterial Stiffness: Theory, Evidence and Perspectives

The Role of a Novel Arterial Stiffness Parameter, Cardio-Ankle Vascular Index (CAVI), as a Surrogate Marker for Cardiovascular Diseases

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