Abstract 17051: Bromocriptine Improves Central Aortic Stiffness in Adolescents With Type 1 Diabetes Mellitus: Arterial Health Results From the BCQR-T1D Study

Abstract

Introduction: The presence of global vascular dysfunction is a well-recognized feature in youth with type 1 diabetes (T1D). This predisposes young patients to the life-long exposure and increased incidence of cardiovascular events. Therapeutic strategies to mitigate vascular dysfunction are urgently needed. Hypothesis: We hypothesized that bromocriptine quick release (BCQR) therapy would improve vascular health in youth with T1D. Methods: This was a placebo-controlled, random-order, double-blinded, cross-over study investigating BCQR as adjunct therapy on central aortic stiffness as measured by phase-contrast MRI. Participants also underwent flow mediated dilation test and brachial distensibility evaluation using tonometry. Adolescents with T1DM were randomized 1:1 to phase-1 of 4-week BCQR (minimum dose 1.6 mg daily) or placebo therapy after which all vascular measurements were performed. Following a 4-week washout period, phase 2 was performed in identical fashion with the alternate treatment. Results: Forty-two adolescents (mean age 15.9 yrs, HbA1c 8.6%, BMI %ile 71.4, TD duration 5.8 yrs) with T1D were enrolled. BCQR therapy decreased systolic (Δ = -5 mmHg, p < 0.001) and diastolic blood pressure (Δ = -2 mmHg, p = 0.039). BCQR therapy reduced ascending aortic PWV (Δ = -0.4 m/s, p = 0.005), and increased RAC (Δ = -2.6%, p = 0.022), and distensibility (Δ = 0.08 %/mmHg, p = 0.010). In the thoraco-abdominal aorta, BCQR decreased PWV (Δ = -0.2 m/s, p = 0.013) and increased distensibility (Δ = 0.05 %/mmHg, P = 0.032) (FIGURE). In contrast, BCQR decreased RHI (Δ = -0.34, p = 0.006). Conclusions: BCQR therapy improved central aortic stiffness and pressure hemodynamics in adolescents with T1D over 4 weeks. However, BCQR decreased peripheral RHI. BCQR therapy might serve as a potential clinical intervention to attenuate accelerated aortic stiffness in youth with T1D supporting future longer-term studies.