Decreased stroke volume−brachial pulse pressure ratio in patients with type 2 diabetes over 50 years: the role of peripheral neuropathy.
Nutr Metab Cardiovasc Dis
; 23(11): 1093-100, 2013 Nov.
Article
em En
| MEDLINE
| ID: mdl-23541167
ABSTRACT
BACKGROUND AND AIMS:
To document the stroke volume to pulse pressure ratio (SV/PP, an index of total arterial compliance) and its correlates in patients with type 2 diabetes (T2DM) aged over 50 years whose peripheral neuropathy and silent myocardial ischemic (SMI) status were known. METHODS ANDRESULTS:
A total of 360 patients with T2DM aged ≥ 50 years, without cardiac history or symptom, left ventricular systolic dysfunction, dilatation and hypokinesia, were retrospectively enrolled. The SV/PP was calculated from echocardiographic left ventricular measurements and brachial blood pressure at rest. Peripheral neuropathy was defined as the presence of any two or more of the following neuropathic symptoms, decreased distal sensation, or decreased or absent ankle reflexes. SMI was defined as an abnormal stress myocardial scintigraphy and/or stress echocardiography. A low SV/PP ratio (<0.53 ml/m²/mmHg, first tertile) was associated with age, creatinine clearance, 24 h urinary albumin excretion rate, peripheral neuropathy, hypertension, serum total cholesterol and triglycerides levels (p < 0.05-0.0001). In multivariate analysis, age (OR 1.1 [1.0-1.2], p < 0.01), triglycerides (OR 1.5 [1.2-2.0], p = 0.01) and peripheral neuropathy (OR 2.2 [1.2-3.9], p = 0.009) were independently associated with a low SV/PP. The patients with peripheral neuropathy had lower SV (p < 0.01) and higher PP (p < 0.05) than those without, and only lower SV after adjustment for age and nephropathy. Similar results were obtained in the patients with and without SMI.CONCLUSION:
Peripheral neuropathy was independently associated with decreased SV/PP, mainly through decreased SV, in patients with T2DM over 50 years.Palavras-chave
CAN; Cardiac autonomic neuropathy; Diabetes; PP; Peripheral neuropathy; SMI; SV; Silent myocardial ischemia; Stroke volumebrachial pulse pressure ratio; T2DM; Total arterial compliance; UAER; cardiac autonomic neuropathy; pulsed pressure; silent myocardial ischemia; stroke volume; type 2 diabetes mellitus; urinary albumin excretion rate
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Envelhecimento
/
Isquemia Miocárdica
/
Sistema Nervoso Periférico
/
Diabetes Mellitus Tipo 2
/
Neuropatias Diabéticas
/
Cardiomiopatias Diabéticas
/
Ventrículos do Coração
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Nutr Metab Cardiovasc Dis
Ano de publicação:
2013
Tipo de documento:
Article