Abstract
The accurate measurement of arterial wave properties in terms of arterial wave transit time (τw) and wave reflection factor (Rf) requires simultaneous records of aortic pressure and flow signals. However, in clinical practice, it will be helpful to describe the pulsatile ventricular afterload using less-invasive parameters if possible. We investigated the possibility of systolic aortic pressure-time area (PTAs), calculated from the measured aortic pressure alone, acting as systolic workload imposed on the rat diabetic heart. Arterial wave reflections were derived using the impulse response function of the filtered aortic input impedance spectra. The cardiovascular condition in the rats with either type 1 or type 2 diabetes was characterized by (1) an elevation in PTAs; and (2) an increase in Rf and decrease in τw. We found that an inverse linear correlation between PTAs and arterial τw reached significance (τw = 38.5462 − 0.0022 × PTAs; r = 0.7708, P < 0.0001). By contrast, as the PTAs increased, the reflection intensity increased: Rf = –0.5439 + 0.0002 × PTAs; r = 0.8701; P <0 .0001. All these findings suggested that as diabetes stiffened aortas, the augmented aortic PTAs might act as a useful index describing the diabetes-related deterioration in systolic ventricular workload.
Highlights
Diabetes mellitus (DM) is a complex metabolic disorder[8,9], which is thought to be responsible for impaired hemodynamic load[10,11] and manifests the diabetic cardiomyopathy[12,13]
We investigated the possibility of systolic aortic pressure-time area (PTAs) acting as systolic left ventricular (LV) workload in rats with diabetes
Because LV relaxation is influenced by hemodynamic load[11], we investigated the influence of the aortic PTAs on LV myocardial relaxation
Summary
Diabetes mellitus (DM) is a complex metabolic disorder[8,9], which is thought to be responsible for impaired hemodynamic load[10,11] and manifests the diabetic cardiomyopathy[12,13]. We investigated the possibility of systolic aortic pressure-time area (PTAs) acting as systolic LV workload in rats with diabetes. The arterial τw was derived to describe the timing of the pulse wave reflection[11,14]. The arterial Rf was derived to describe the intensity of the pulse wave reflection[15]. We found that as diabetes stiffened aortas, the aortic PTAs was augmented and could reflect the diabetes-related deterioration in arterial wave properties. Because LV relaxation is influenced by hemodynamic load[11], we investigated the influence of the aortic PTAs on LV myocardial relaxation. Myocardial relaxation was measured indirectly by assessing the time constant of LV isovolumic pressure decay (τe)[16]. We found that as the aortic PTAs increased with diabetes, the LV τe became more prolonged and the late pressure relaxation slowed
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