Diabetes Complications Unit, Vascular Division, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
Diabet Med. 2011 Jan;28(1):54-60. doi: 10.1111/j.1464-5491.2010.03146.x.
To comprehensively characterize large artery biomechanical properties and examine their relationship to cardiac function in patients with Type 2 diabetes mellitus (DM).
Fifty-five individuals with Type 2 DM were compared with 66 age- and sex-matched healthy control subjects. Arterial biomechanical properties were assessed by systemic arterial compliance (SAC; two-element Windkessel model), carotid-femoral pulse wave velocity (PWVc-f), femoral-dorsalis pedis pulse wave velocity (PWVf-d) and carotid augmentation index. Cardiac structure and function were assessed by echocardiography.
Individuals with Type 2 DM had lower SAC and higher PWVc-f when compared with the healthy population. The PWVc-f was significantly lower than the PWVf-d in control individuals, but this difference was not evident in individuals with Type 2 DM due to higher PWVc-f. Augmentation index was similar in both groups, but the time to the first systolic inflection (time to reflection) was shorter in the individuals with Type 2 DM. The individuals with Type 2 DM had a greater prevalence of diastolic abnormalities when compared with the control group. Arterial stiffness indices, including SAC and pulse pressure, correlated with left ventricular filling pressure (defined as peak velocity during early diastolic filling divided by the velocity of movement of the mitral valve annulus in early diastole; r = -0.33 and 0.36 respectively.
Patients with Type 2 DM on standard medication showed preferential stiffening of the large central arteries. However, carotid augmentation index was not different between the two groups and is therefore not a reliable indicator of large artery stiffening in this patient group. Diastolic dysfunction, present in a significant proportion of this population with Type 2 DM, was closely associated with arterial stiffening, suggesting a common aetiology.
全面描述大动脉生物力学特性，并研究其与 2 型糖尿病患者心脏功能的关系。
将 55 例 2 型糖尿病患者与 66 名年龄、性别匹配的健康对照者进行比较。采用两元素 Windkessel 模型评估大动脉弹性（SAC）、颈股脉搏波速度（PWVc-f）、股足背脉搏波速度（PWVf-d）和颈动脉增强指数。采用超声心动图评估心脏结构和功能。
与健康人群相比，2 型糖尿病患者的 SAC 降低，PWVc-f 升高。在对照组中，PWVc-f 显著低于 PWVf-d，但在 2 型糖尿病患者中，由于 PWVc-f 较高，这种差异并不明显。两组的增强指数相似，但 2 型糖尿病患者的首次收缩期内折时间（反射时间）更短。与对照组相比，2 型糖尿病患者舒张功能异常更为常见。动脉僵硬度指标，包括 SAC 和脉压，与左心室充盈压（定义为舒张早期充盈峰值速度除以舒张早期二尖瓣环运动速度；r = -0.33 和 0.36）相关。
接受标准药物治疗的 2 型糖尿病患者表现出大中央动脉优先僵硬。然而，两组间颈动脉增强指数无差异，因此不是该患者群体大动脉僵硬的可靠指标。舒张功能障碍在该 2 型糖尿病患者人群中占相当大的比例，与动脉僵硬密切相关，提示存在共同的发病机制。
