open access

Vol 20, No 6 (2013)
Original articles
Published online: 2013-12-11
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Associations of fractional pulse pressure to aortic stiffness and their impact on diastolic function and coronary flow reserve in asymptomatic diabetic patients with normal coronary angiography

Ragab A. Mahfouz, Waleed Elawady, Mohamed Abdu, Abdelhakem Salem
DOI: 10.5603/CJ.2013.0160
·
Cardiol J 2013;20(6):605-611.

open access

Vol 20, No 6 (2013)
Original articles
Published online: 2013-12-11

Abstract

Background: We aimed to assess the relation of fractional pulse pressure (PPf) to aortic stiffness index and their impact on coronary fl ow 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 signifi cantly 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.

Abstract

Background: We aimed to assess the relation of fractional pulse pressure (PPf) to aortic stiffness index and their impact on coronary fl ow 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 signifi cantly 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.

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Keywords

pulse pressure, diabetes mellitus, diastolic function, coronary flow

About this article
Title

Associations of fractional pulse pressure to aortic stiffness and their impact on diastolic function and coronary flow reserve in asymptomatic diabetic patients with normal coronary angiography

Journal

Cardiology Journal

Issue

Vol 20, No 6 (2013)

Pages

605-611

Published online

2013-12-11

DOI

10.5603/CJ.2013.0160

Bibliographic record

Cardiol J 2013;20(6):605-611.

Keywords

pulse pressure
diabetes mellitus
diastolic function
coronary flow

Authors

Ragab A. Mahfouz
Waleed Elawady
Mohamed Abdu
Abdelhakem Salem

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