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Pulse wave analysis and prevalent cardiovascular disease in type 1 diabetes

Catherine T Prince1, Aaron M Secrest, Rachel H Mackey

  • 1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.

Atherosclerosis
|October 1, 2010
PubMed

Insights

Augmentation pressure and subendocardial viability ratio may help assess cardiovascular risk in type 1 diabetes. These pulse wave analysis measures are linked to coronary artery disease and arterial stiffness in T1D patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Biology

Background:

  • Type 1 diabetes (T1D) significantly increases the risk of premature cardiovascular disease (CVD), including coronary artery calcification (CAC) and lower extremity arterial disease (LEAD).
  • Pulse wave analysis (PWA) measures arterial stiffness, but its relationship with CVD markers in T1D remains understudied.

Purpose of the Study:

  • To investigate the association between PWA-derived arterial stiffness indices and cardiovascular disease markers in individuals with childhood-onset T1D.
  • To determine if PWA measures can help characterize CVD risk in this population.

Main Methods:

  • 144 participants with childhood-onset T1D underwent PWA using the SphygmoCor Px device.
  • Cross-sectional analysis examined associations between augmentation pressure (AP), augmentation index (AIx), subendocardial viability ratio (SEVR), and prevalent coronary artery disease (CAD), CAC, and low ankle-brachial index (ABI).

Main Results:

  • Higher AP and lower SEVR were initially linked to prevalent CAD, high CAC, and low ABI.
  • After age adjustment, AP and SEVR associations with CAD and CAC were no longer significant.
  • In non-nitrate users, higher AP was independently associated with CAD events and explained more variance than age or blood pressure.
  • SEVR remained associated with low ABI in multivariable models.

Conclusions:

  • Elevated augmentation pressure is independently associated with prevalent CAD and impaired myocardial perfusion (low SEVR) in type 1 diabetes.
  • These PWA measures may enhance CVD risk stratification in T1D and warrant prospective investigation.
Abstract

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