Cerebral vasoreactivity in hypocapnia and hypercapnia in patients with diabetes mellitus type 2 with or without arterial hypertension

Abstract

Background and purpose

Diabetes mellitus (DM) is an independent risk factor for cardiovascular diseases. The origin of diabetic microangiopathy is multifactorial; it affects all layers of the artery wall, causing endothelial and vasoreactivity impairment. The incidence of cerebral vasoreactivity failure in diabetic patients without stroke history is not precisely determined yet. The aim of the study was to assess the cerebrovascular reactivity in hypocapnia and hypercapnia in patients with type 2 DM with or without arterial hypertension without artery stenosis and stroke history, with the use of transcranial Doppler examination.

Material and methods

The mean blood flow velocity, pulsatility index and parameters of cerebrovascular reactivity were measured in 53 patients with type 2 DM (aged 42–72 years, mean 59.5 ± 7.9) and in 27 healthy volunteers (aged 36–74 years, mean 57.0 ± 10.4). Diabetics were further divided into two subgroups according to the presence or absence of arterial hypertension.

Results

The index of cerebrovascular reactivity in hypocapnia and hypercapnia was significantly worse and time needed to normalization of blood flow velocity was significantly longer in patients with DM in comparison with healthy volunteers.

Conclusions

Most DM type 2 patients without stroke history had decreased values of cerebral vasoreactivity parameters, which suggests the presence of microangiopathy.