BACKGROUND: We aimed to assess the relation of fractional pulse pressure (PPf) to aortic stiffness index and their impact on coronary flow reserve (CFR) and left ventricular diastolic function in asymptomatic diabetic patients. METHODS: One hundred and thirty five consecutive asymptomatic diabetic patients (aged 48.8 ± 7.84 years), were included. CFR was calculated noninvasively using transthoracic echo-Doppler assessment with hyperemia induced by infusion of dipyridamole at a rate of 0.56 mg/kg over 4 min. PPf was calculated as pulse pressure divided by mean arterial pressure (SBP - DBP/MAP), while diastolic function was evaluated by means of transmitral flow and tissue Doppler imaging. Aortic stiffness indices (ASI) were measured as previously described. RESULTS: Diabetic patients with low CFR (n = 52) compared with those with normal CFR (n = 83) exhibited significantly increased PPf (75.2 ± 11.4 vs. 64.5 ± 6.7, p < 0.001). PPf was significantly correlated with ASI (r = 0.520, p < 0.001), E/Em ratio (r = 0.425,p < 0.001) and left atrial volume index (r = 0.462, p < 0.001). CFR was negatively correlated with both PPf (r = -0.68, p < 0.0001). After applying multivariate linear regression analysis,after correction for cardiovascular risk factors, importantly, PPf and ASI remained significant predictors of CFR (p < 0.0001 and p < 0.001, respectively). CONCLUSIONS: PPf was significantly correlated to ASI in asymptomatic diabetic patients. Likewise, increased PPf was associated with impaired CFR and subclinical diastolic dysfunction in diabetic patients. PPf could be utilized as a simple non-invasive predictor of occult atherosclerosis and diastolic dysfunction in diabetic patients.
BACKGROUND: We aimed to assess the relation of fractional pulse pressure (PPf) to aortic stiffness index and their impact on coronary flow reserve (CFR) and left ventricular diastolic function in asymptomatic diabeticpatients. METHODS: One hundred and thirty five consecutive asymptomatic diabeticpatients (aged 48.8 ± 7.84 years), were included. CFR was calculated noninvasively using transthoracic echo-Doppler assessment with hyperemia induced by infusion of dipyridamole at a rate of 0.56 mg/kg over 4 min. PPf was calculated as pulse pressure divided by mean arterial pressure (SBP - DBP/MAP), while diastolic function was evaluated by means of transmitral flow and tissue Doppler imaging. Aortic stiffness indices (ASI) were measured as previously described. RESULTS:Diabeticpatients with low CFR (n = 52) compared with those with normal CFR (n = 83) exhibited significantly increased PPf (75.2 ± 11.4 vs. 64.5 ± 6.7, p < 0.001). PPf was significantly correlated with ASI (r = 0.520, p < 0.001), E/Em ratio (r = 0.425,p < 0.001) and left atrial volume index (r = 0.462, p < 0.001). CFR was negatively correlated with both PPf (r = -0.68, p < 0.0001). After applying multivariate linear regression analysis,after correction for cardiovascular risk factors, importantly, PPf and ASI remained significant predictors of CFR (p < 0.0001 and p < 0.001, respectively). CONCLUSIONS:PPf was significantly correlated to ASI in asymptomatic diabeticpatients. Likewise, increased PPf was associated with impaired CFR and subclinical diastolic dysfunction in diabeticpatients. PPf could be utilized as a simple non-invasive predictor of occult atherosclerosis and diastolic dysfunction in diabeticpatients.
Authors: Cengiz Burak; Muhammed Süleymanoğlu; Mahmut Yesin; Murat Cap; İbrahim Yıldız; İbrahim Rencüzoğulları; Metin Çağdaş; Yavuz Karabağ; Şerif Hamideyin; Doğan İliş; Erkan Baysal Journal: Med Princ Pract Date: 2020-04-28 Impact factor: 1.927
Authors: Maria Lembo; Rosa Sicari; Roberta Esposito; Fausto Rigo; Lauro Cortigiani; Francesco Lo Iudice; Eugenio Picano; Bruno Trimarco; Maurizio Galderisi Journal: J Am Heart Assoc Date: 2017-06-29 Impact factor: 5.501