Increased Arterial Augmentation and Augmentation Index as Surrogate Parameters for Arteriosclerosis in Subjects with Diabetes Mellitus and Nondiabetic Subjects with Cardiovascular Disease

Abstract

Background:Arterial augmentation (AP) and the augmentation index (Aix) are surrogate parameters of arterial stiffness and are commonly used as predictors for cardiovascular risk. The aim of this study is to compare these parameters in diabetic subjects and nondiabetic cardiovascular risk subjects with healthy control subjects. Methods:One hundred sixty-six nonsmoking subjects aged between 35 and 70 years were included in the study, which included 100 subjects with cardiovascular disease but not diabetes (mean age 62.73±8.75 years), 33 subjects with type 2 diabetes (66.58±2.69 years), and 33 healthy controls (51.89±8.91 years). In these subjects, arterial stiffness was measured by the difference between the second and the first systolic peak of the central pressure waveform, and the Aix was calculated as the percentage of Aix from pulse pressure. Results:Arterial augmentation was increased in subjects with diabetes (DM) with 10.21±6.97 mm Hg and in subjects with cardiovascular disease but not diabetes (CV) with 10.74±5.29 mm Hg in comparison to healthy controls (C) with 6.59±3.97 mm Hg (p < 0.0005 DM vs C; p < 0.00005 CV vs C). Moreover, Aix was increased with 26.00±9.91% in CV subjects compared to healthy controls with 19.84±9.37% (p < 0.02 CV vs C). The augmentation index was increased with 21.12±11.21% in subjects with type 2 diabetes mellitus compared to controls, but failed to be statistically significant. There was no statistical significance in arterial augmentation or the augmentation index between CV and diabetic subjects. Conclusion:The results of our study revealed a comparable increased augmentation index as a surrogate measure of arterial stiffness and arteriosclerosis in subjects with diabetes mellitus and in nondiabetic subjects with cardiovascular disease. J Diabetes Sci Technol 2007; 2:260-263 Journal of Diabetes Science and Technology

Fatores associados ao aumento no índice de incremento de pressão radial em indivíduos hipertensos

“…Guiadoni et al 37 also did not found any difference for AI between normotensive patients with and without metabolic syndrome. This same trend was observed by Wilhelm et al in a comparison between type 2 DM and controls 38 . On the other hand, Wilkinson et al 39 showed that AI was significantly high in diabetic patients compared with controls matched by sex, age, weight and height.…”

Relationship of systemic endothelial function and peripheral arterial stiffness with diabetic retinopathy

“…Measurements of AI using various devices have shown differences between diabetic subjects and non-diabetic subjects. Wilhelm et al 24 showed increased AI and arteriosclerosis in subjects with DM and in non-diabetic subjects with cardiovascular disease. In a comparison of young patients with type 1 diabetes and normal controls, Palombo et al 25 showed that diabetic patients had higher AI values than controls.…”

Investigation of the vascular and pleiotropic effects of atorvastatin and pioglitazone in a population at high cardiovascular risk

“…After 20 sequential waveforms had been recorded, a validated generalised transfer function was used to generate the corresponding central aortic pressure waveform. 18 Augmentation pressure was calculated as the difference between the second and the first systolic shoulder of the central pressure wave curve and the augmentation index was expressed as the percentage of AP compared to the total pulse pressure. All recordings were performed with the patient lying down in a quiet room after a rest of at least 10 minutes, and the Aix was normalised to a heart rate of 75 bpm (Aix@75).…”