Endocrinol Metab.  2011 Mar;26(1):44-52. 10.3803/EnM.2011.26.1.44.

Relationships between Cardiac Autonomic Neuropathy and the Brachial-ankle Pulse Wave Velocity in Patients with Type 2 Diabetes

• Bae YP
• Yi BD
• Kim BG
• Park JH
• Kwon YS
• Park JY
• Lee CW
• Kim BH
• Jang JS

• KMID: 2169124
• DOI: http://doi.org/10.3803/EnM.2011.26.1.44

Abstract

BACKGROUND
Cardiovascular disease is the leading cause of death in patients with type 2 diabetes. Clinically, evaluating cardiovascular autonomic neuropathy (CAN) is important to predict cardiovascular mortality because it is correlated with cardiovascular death. The pulse wave velocity (PWV) correlates well with arterial distensibility and stiffness. It is also a useful approach for evaluating the severity of systemic atherosclerosis in adults. So, we evaluated that the relationship between cardiac autonomic neuropathy and the brachial-ankle pulse wave velocity (baPWV) in patients with type 2 diabetes.
METHODS
We retrospectively analyzed 465 patients (209 men and 256 women) with type 2 diabetes. We checked the clinical characteristics and the laboratory tests and we assessed the diabetic complications. Standard tests for CAN were performed by DiCAN (Medicore, Seoul, Korea): 1) heart rate variability during deep breathing (the E/I ratio), 2) a Valsalva maneuver, 3) 30:15 ratio of R-R interval the blood pressure response to standing, and 5) the blood pressure response to handgrip. The CAN score was determined according to the results of the test as following: 0 = normal, 0.5 = borderline, 1 = abnormal. We also measured the baPWV by using a VP 1000 (Colin, Japan) and all the analyses were performed with the SPSS version 14.0. P values < 0.05 were considered significant.
RESULTS
The CAN score is associated with the maximal baPWV, age, systolic blood pressure, microalbuminuria, the duration of diabetes, angiotensin II receptor blocker treatment, calcium channel blocker treatment, beta-blocker treatment and nephropathy. After adjusting for age, the baPWV is a independent predictor of the risk for CAN (beta = 0.108, P = 0.021).
CONCLUSION
The CAN is associated with the baPWV in patient with type 2 diabetes.

Keyword

Brachial-ankle pulse-wave velocity; Cardiovascular atonomic neuropathy; Type 2 diabetes

MeSH Terms

Adult
Atherosclerosis
Blood Pressure
Calcium Channels
Cardiovascular Diseases
Cause of Death
Diabetes Complications
Heart Rate
Humans
Male
Pulse Wave Analysis
Receptors, Angiotensin
Respiration
Retrospective Studies
Valsalva Maneuver
Calcium Channels
Receptors, Angiotensin

Figure

• 

  Fig. 1 Relationship between maximal brachial-ankle pulse wave velocity and cardiovascular autonomic neuropathy score. There was significant positive correlation between maximal pulse wave velocity and cardiovascular autonomic neuropathy score (r = 0.212, P < 0.01).

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