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Increases in central aortic impedance precede alterations in arterial stiffness measures in type 1 diabetes

Nancy K Sweitzer1, Mohan Shenoy, James H Stein

  • 1Department of Cardiovascular Medicine, University of Wisconsin, Madison, Wisconsin, USA. nks@medicine.wisc.edu

Diabetes Care
|August 10, 2007
PubMed

Insights

Early type 1 diabetes is linked to increased central aortic impedance (Z(c)) and pulse pressure, potentially contributing to kidney damage. Pulse wave velocity (PWV) remains unchanged, indicating Z(c) is an early indicator.

Area of Science:

  • Cardiovascular research
  • Diabetology
  • Vascular physiology

Background:

  • Increased pulse pressure is a known cardiovascular risk factor in diabetes.
  • Central aortic properties can influence microvascular perfusion and cardiac function.

Purpose of the Study:

  • To identify early alterations in central arterial properties in young individuals with type 1 diabetes.
  • To investigate the relationship between arterial stiffness and early diabetic complications.

Main Methods:

  • Arterial stiffness and hemodynamics measured using calibrated tonometry and pulsed Doppler in 17 type 1 diabetes patients and controls.
  • Aortic characteristic impedance (Z(c)) calculated from carotid pressure and aortic flow.
  • Pulse wave velocity (PWV) assessed via tonometry and body surface measurements.

Main Results:

  • Type 1 diabetes patients exhibited elevated central pulse pressure (45 vs. 36 mmHg) and peripheral pulse pressure (54 vs. 43 mmHg).
  • Aortic characteristic impedance (Z(c)) was significantly higher in type 1 diabetes patients (179 vs. 136 dynes x s/cm5).
  • Pulse wave velocity (PWV) showed no significant difference between groups; Z(c) correlated with urinary albumin excretion.

Conclusions:

  • Aortic characteristic impedance (Z(c)) is elevated early in type 1 diabetes, preceding changes in PWV.
  • Increased Z(c) and pulse pressure may contribute to renal microvascular damage in diabetes.
  • Z(c) serves as a sensitive marker for early vascular changes in type 1 diabetes.
Abstract

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