Document Detail


Pulse wave analysis and prevalent cardiovascular disease in type 1 diabetes.
MedLine Citation:
PMID:  20880527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Type 1 diabetes (T1D) is associated with a high risk for and mortality from premature coronary artery disease (CAD), including coronary artery calcification (CAC), a subclinical marker, and lower extremity arterial disease (LEAD). Pulse wave analysis (PWA) arterial stiffness indices have been associated with cardiovascular disease (CVD) risk factors and outcomes in various populations, but little is known regarding these relationships in T1D.
METHODS: PWA was performed using the SphygmoCor Px device on 144 participants in the Pittsburgh EDC Study of childhood-onset T1D. The cross-sectional associations between arterial stiffness indices, augmentation index (AIx) and augmentation pressure (AP), and subendocardial viability ratio (SEVR), an estimate of myocardial perfusion, with prevalent CAD, electron beam computed tomography-measured CAC and low (<0.90) ankle-brachial index (ABI) were examined.
RESULTS: Higher AP (but not AIx) and lower SEVR were univariately associated with prevalent CAD, high CAC score, and low ABI. AP and SEVR's association with CAD and CAC did not, however, remain significant after adjustment for age. In individuals not using nitrates, which profoundly affect PWA measures, AP was significantly higher in those with CAD events and explained more of the variance than either age or brachial blood pressure measures. SEVR was associated with low ABI in multivariable models.
CONCLUSIONS: Greater augmentation pressure is independently associated with prevalent CAD and estimated myocardial perfusion with low ABI in type 1 diabetes. These measures may thus help to better characterize CVD risk in type 1 diabetes and need to be examined prospectively.
Authors:
Catherine T Prince; Aaron M Secrest; Rachel H Mackey; Vincent C Arena; Lawrence A Kingsley; Trevor J Orchard
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-09-15
Journal Detail:
Title:  Atherosclerosis     Volume:  213     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-06     Completed Date:  2011-03-18     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  469-74     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Flow Velocity
Calcinosis / radiography
Cardiovascular Diseases / epidemiology*,  radiography
Cardiovascular Physiological Phenomena
Coronary Artery Disease / physiopathology,  radiography
Diabetes Mellitus, Type 1 / complications,  physiopathology*,  radiography
Female
Humans
Male
Middle Aged
Pennsylvania / epidemiology
Prevalence
Pulsatile Flow
Tomography, X-Ray Computed
Vascular Resistance
Grant Support
ID/Acronym/Agency:
F30 DK082137-04/DK/NIDDK NIH HHS; F30-DK082137/DK/NIDDK NIH HHS; R01 DK034818-24/DK/NIDDK NIH HHS; R01-DK034818/DK/NIDDK NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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