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Correlation between Diastolic Function and Endothelial Function in Patients with Type 2 Diabetes and Hypertension

Ricardo Bedirian1, Mario Fritsch Neves1, Wille Oigman1

  • 1Department of Clinical Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.

The Open Cardiovascular Medicine Journal
|November 22, 2016
PubMed

Insights

Endothelial dysfunction is more prevalent in hypertensive patients with type 2 diabetes and diastolic dysfunction. Flow-mediated dilation (FMD) reveals significant correlations between endothelial and diastolic function indexes.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Diabetology

Background:

  • Endothelial dysfunction is implicated in cardiac abnormalities in diabetes mellitus (DM).
  • While a link between endothelial and diastolic dysfunction exists in type 1 DM, it's less studied in type 2 DM.
  • Hypertension exacerbates cardiovascular risks in diabetic patients.

Purpose of the Study:

  • To compare endothelial function in type 2 diabetic patients with and without diastolic dysfunction.
  • To investigate correlations between endothelial function and diastolic function indexes.
  • To assess endothelial function using flow-mediated dilation (FMD) in this patient group.

Main Methods:

  • Cross-sectional study of 34 patients (40-70 years) with type 2 DM and hypertension.
  • Patients categorized into normal (14) and abnormal (20) diastolic function groups via Doppler echocardiography.
  • Endothelial function assessed using brachial artery flow-mediated dilation (FMD).

Main Results:

  • Mean maximum FMD was significantly lower in patients with diastolic dysfunction (7.15 ± 2.80%) compared to those with normal function (11.85 ± 4.77%).
  • Significant correlations were found between maximum FMD and E/e' ratio (p=0.040, r=-0.354).
  • Maximum FMD also correlated with early wave velocity (e') at the lateral mitral annulus (p=0.002, r=0.509).

Conclusions:

  • Endothelial function, assessed by FMD, is impaired in hypertensive type 2 diabetic patients with diastolic dysfunction.
  • The study confirms correlations between diastolic and endothelial function indexes in this population.
  • Findings highlight the clinical relevance of assessing endothelial function in diabetic patients with hypertension and diastolic dysfunction.
Abstract

Keywords:
Arterial intimaDiabetes mellitusDiastoleDoppler echocardiographyDoppler ultrasonographyEndotheliumHypertensionLeft ventricle

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