Carotid stiffness parameters are earlier markers of subclinical atherosclerosis than central aortic systolic pressure in patients with type 2 diabetes mellitus

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Elevated central aortic systolic pressure (CASP) is a stronger predictor of atherosclerosis than peripherial blood pressure measurement. One-point echo-tracking is a novel noninvasive method for measurement of the local arterial stiffness (AS) of carotid artery (CA). As the cardio-vascular complications of patients with type 2 Diabetes Mellitus (T2DM) are the most clinically significant, establishing early signs of atherosclerosis is of utmost importance for the prognosis Purpose To compare the significance of CASP and of carotid echo-tracking parameters as early signs of atherosclerosis in patients T2DM without cardio-vascular disease Patients and methods 100 patients with T2DM without overt cardio-vascular diseases and 30 healthy age- and sex-matched controls were included in the study and examined for PWVβ, β-stiffness index, arterial compliance (АС), augmentation index (AI), Peterson’s modulus (Ep) of right CA with Aloka Hitachi Prosound α7. CASP was determined with Caspal A-pulse CASP-AL device. Patients with atrial fibrillation and increased blood pressure were excluded from the study. Results: Тhe mean values of CASP in T2DM were 126.4 mmHg vs 125.7 mmHg in controls (p = 0.84). PWVβ was increased in patients compared to controls: 7.42m/s vs 6.4m/s, p = 0.001. The same changes were found in β-stiffness index - 10.4 vs 7.7 (p = 0.001), AI - 13.3 vs 19.8 9 (p = 0.009), and Ep - 151.3 vs 112.1 (p = 0.001). There was no significant difference in АС - 0.77 vs 0.98 (p = 0.11). There was a mild correlation between the CASP and carotid stiffness indices (Table 1). Conclusions Parameters of local arterial stiffness of carotid artery are earlier signs of subclinical atherosclerosis than CASP in patients with T2DM without cardio-vascular disease. One-point echo tracking is a useful non-invasive and easy to perform novel ultrasound method. Table 1 PWV(L) AC(L) PWV(R) Ep(R) AC(R) AI(R) r p r p r p r p r p r p CASP 0.222 0.045 -.295 0.007 .286 0.011 .273 0.015 -0.214 0.05 .256 0.023 L-left CA, R-right CA