Association of subclinical myocardial injury with arterial stiffness in patients with type 2 diabetes mellitus - PubMed (original) (raw)

Association of subclinical myocardial injury with arterial stiffness in patients with type 2 diabetes mellitus

Kai-Hang Yiu et al. Cardiovasc Diabetol. 2013.

Abstract

Objective: Type 2 diabetes mellitus (T2DM) is associated with subclinical myocardial injury although the underlying mechanism is uncertain. We postulated that arterial stiffness, endothelial dysfunction and subclinical atherosclerosis may contribute to subclinical myocardial injury in patients with T2DM.

Methods: Serum high-sensitivity troponin I (hs-TNI) an indicator of myocardial injury, was measured in 100 patients with T2DM without clinical evidence of macrovascular disease and 150 age and gender-matched controls. Elevated hs-TnI was defined as follow (derived from the 99th percentile from controls): Male >11.1 ng/L; female >7.6 ng/L. Measures that may contribute to myocardial damage in patients with T2DM, including brachial-ankle pulse wave velocity (ba-PWV), brachial flow mediated dilatation (FMD) and carotid intima media thickness (IMT), were also assessed.

Results: The serum level of hs-TNI (5.7 ± 9.2 μg/L vs. 3.2 ± 1.9 μg/L, P< 0.01) and the prevalence of elevated hs-TNI (12% vs. 4%, P = 0.02) were significantly higher in patients with T2DM than controls. Patients with T2DM also had significantly worse ba-PWV (17.98 ± 3.91ms-1 vs. 15.70 ± 2.96 ms-1), brachial FMD (2.6 ± 3.5% vs. 5.5 ± 4.2%, P< 0.01) and carotid IMT (0.96 ± 0.20 mm vs. 0.86 ± 0.14 mm, P< 0.01). In patients with T2DM, hs-TNI was positively correlated with systolic blood pressure (r = 0.31, P<0.01), serum creatinine (r = 0.26, P = 0.01) and ba-PWV (r = 0.34, P< 0.01). Importantly, multiple regression revealed that only ba-PWV was independently associated with hs-TNI (β = 0.25, P = 0.04).

Conclusion: The results demonstrated an independent association between ba-PWV and hs-TNI in patients with T2DM with no clinical evidence of macrovascular disease. These findings suggest that increased arterial stiffness is closely related to subclinical myocardial injury in patients with T2DM.

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Figures

Figure 1

Figure 1

Correlation of arterial stiffness measured by brachial-ankle pulse wave velocity (ba-PWV) with high-sensitivity Troponin I.

Figure 2

Figure 2

Correlation of endothelial function measured brachial flow-mediated dilatation (FMD) with high-sensitivity Troponin I.

Figure 3

Figure 3

Correlation of atherosclerosis measured by carotid intima-media thickness (IMT) with high-sensitivity Troponin I.

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References

    1. Kannel WB, McGee DL. Diabetes and cardiovascular risk factors: the Framingham study. Circulation. 1979;59:8–13. doi: 10.1161/01.CIR.59.1.8. - DOI - PubMed
    1. The Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375:2215–2222. doi: 10.1016/S0140-6736(10)60484-9. - DOI - PMC - PubMed
    1. Rubin J, Matsushita K, Ballantyne CM, Hoogeveen R, Coresh J, Selvin E. Chronic hyperglycemia and subclinical myocardial injury. J Am Coll Cardiol. 2012;59:484–489. doi: 10.1016/j.jacc.2011.10.875. - DOI - PMC - PubMed
    1. Ng AC, Delgado V, Bertini M, van der Meer RW, Rijzewijk LJ, Shanks M, Nucifora G, Smit JW, Diamant M, Romijn JA, de Roos A, Leung DY, Lamb HJ, Bax JJ. Findings from left ventricular strain and strain rate imaging in asymptomatic patients with type 2 diabetes mellitus. Am J Cardiol. 2009;104:1398–1401. doi: 10.1016/j.amjcard.2009.06.063. - DOI - PubMed
    1. Everett BM, Cook NR, Magnone MC, Bobadilla M, Kim E, Rifai N, Ridker PM, Pradhan AD. Sensitive cardiac troponin T assay and the risk of incident cardiovascular disease in women with and without diabetes mellitus: the Women's Health Study. Circulation. 2011;123:2811–2818. doi: 10.1161/CIRCULATIONAHA.110.009928. - DOI - PMC - PubMed

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