Endocrinology and Metabolism

Original Articles

Diabetes
High Brachial Ankle Pulse Wave Velocity as a Marker for Predicting Coronary Artery Stenosis in Patients with Type 2 Diabetes: Bo Hyun Kim, Jae Sik Jang, Yong Seop Kwon, June Hyung Kim, In Joo Kim, Chang Won Lee; Endocrinol Metab. 2018;33(1):88-96. Published online March 21, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.1.88

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Background

We evaluated the ability of brachial ankle pulse wave velocity (baPWV) to predict coronary artery stenosis (CAS) in patients with type 2 diabetes, and compared the predictive power of baPWV to that of well-known cardiovascular disease (CVD) risk calculators.

Methods

The study group included 83 consecutive patients over 30 years old with type 2 diabetes who complained of vague chest discomfort. An automatic pulse waveform analyzer was used to measure baPWV. CAS was measured using multi-slice computed tomographic (MSCT) angiography.

Results

Age, maximal baPWV, duration of diabetes, current smoking, the UK Prospective Diabetes Study (UKPDS) Risk Engine score, American College of Cardiology/American Heart Association (ACC/AHA) risk estimator score, the Framingham risk calculator score, and coronary artery calcium score were greater in patients with CAS than in those without CAS. An area under the curve (AUC) indicative of a predictive value for CAS (≥20%) was found for several parameters. The AUC of maximal baPWV, the UKPDS Risk Engine, the ACC/AHA ASCVD risk estimator, and the Framingham risk calculator were 0.672 (95% confidence interval [CI], 0.554 to 0.785; P=0.010), 0.777 (95% CI, 0.675 to 0.878; P<0.001), 0.763 (95% CI, 0.660 to 0.866; P<0.001), and 0.736 (95% CI, 0.629 to 0.843; P<0.001), respectively. The optimal cutoff value of baPWV for the detection of CAS was 1,650 cm/sec (sensitivity, 68.9%; specificity, 63.2%).

Conclusion

Maximal baPWV was closely related with CAS detected by MSCT coronary angiography in patients with type 2 diabetes. baPWV has the potential to be a useful, noninvasive screening tool for the prediction of occult CAS in patients with type 2 diabetes.

Citations

Citations to this article as recorded by

Polyvinyl Alcohol Phantoms With Heterogeneous Plaques: Estimation of Pulse Wave Velocity at the Stenotic Region Using Pulse Wave Imaging
Nima Mobadersany, Pengcheng Liang, Paul Kemper, Elisa E. Konofagou
Ultrasound in Medicine & Biology.2024; 50(1): 91. CrossRef
The risk factors of early arterial stiffness in type 2 diabetes without diabetic macroangiopathy
Jia-Hui Wu, Rui Wang, Xiao-Jiao Jia, Na Lu, Qiang Lu, Fu-Zai Yin, Chun-Ming Ma
International Journal of Diabetes in Developing Countries.2023;[Epub] CrossRef
Arterial Stiffness as a Predictor of the Index of Atherosclerotic Cardiovascular Disease in Hypertensive Patients
Guili Chang, Yueliang Hu, Qian Ge, Shaoli Chu, Alberto Avolio, Junli Zuo
International Journal of Environmental Research and Public Health.2023; 20(4): 2832. CrossRef
Pulse wave imaging of a stenotic artery model with plaque constituents of different stiffnesses: Experimental demonstration in phantoms and fluid-structure interaction simulation
Nima Mobadersany, Nirvedh H. Meshram, Paul Kemper, C.V. Sise, Grigorios M. Karageorgos, Pengcheng Liang, Gerard A. Ateshian, Elisa E. Konofagou
Journal of Biomechanics.2023; 149: 111502. CrossRef
Computational clustering reveals differentiated coronary artery calcium progression at prevalent levels of pulse wave velocity by classifying high-risk patients
Maximo Rousseau-Portalis, Leandro Cymberknop, Ignacio Farro, Ricardo Armentano
Frontiers in Cardiovascular Medicine.2023;[Epub] CrossRef
Pepsinogen ratio and brachial-ankle pulse wave velocity: a cross-sectional study on their interrelationship in atherosclerosis
Yuexi Li, Xiaoqin Liu, Yuhan Luo, Qiaoli Wang
BMC Cardiovascular Disorders.2023;[Epub] CrossRef
The Plasma Atherogenic Index is an Independent Predictor of Arterial Stiffness in Healthy Koreans
Ji Sun Nam, Min Kyung Kim, Kahui Park, Arim Choi, Shinae Kang, Chul Woo Ahn, Jong Suk Park
Angiology.2022; 73(6): 514. CrossRef
Risk assessment indicators and brachial-ankle pulse wave velocity to predict atherosclerotic cardiovascular disease
Hung-Ju Ko, Chuan-Chuan Liu, Po-Jui Hsu, Kuang-Chun Hu, Chung-Lieh Hung, Lo-Yip Yu, Yun-Chieh Huang, Shou-Chuan Shih
Medicine.2022; 101(32): e29609. CrossRef
Brachial-ankle pulse wave velocity as a predictor of long-term cardiovascular events in 2174 subjects with type 2 diabetes mellitus: A retrospective cohort study
Hack-Lyoung Kim, Won Kyeong Jeon, Hyun Sung Joh, Woo-Hyun Lim, Jae-Bin Seo, Sang-Hyun Kim, Joo-Hee Zo, Myung-A Kim
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Ultrasound Methods in the Evaluation of Atherosclerosis: From Pathophysiology to Clinic
Gabriel Cismaru, Teodora Serban, Alexandru Tirpe
Biomedicines.2021; 9(4): 418. CrossRef
A model to predict risk of stroke in middle-aged adults with type 2 diabetes generated from a nationwide population-based cohort study in Korea
Mee-Kyoung Kim, Kyungdo Han, Jae-Hyoung Cho, Hyuk-Sang Kwon, Kun-Ho Yoon, Seung-Hwan Lee
Diabetes Research and Clinical Practice.2020; 163: 108157. CrossRef
Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms
Pinelopi Rafouli‐Stergiou, Ignatios Ikonomidis, Niki Katsiki, Nikolaos P. E. Kadoglou, Stefanos Vlachos, John Thymis, John Parissis, Konstantinos G. Moulakakis, John D. Kakisis
The Journal of Clinical Hypertension.2020; 22(2): 187. CrossRef
Association of serum FAM19A5 with metabolic and vascular risk factors in human subjects with or without type 2 diabetes
You-Bin Lee, Hwan-Jin Hwang, Jung A Kim, Soon Young Hwang, Eun Roh, So-hyeon Hong, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo
Diabetes and Vascular Disease Research.2019; 16(6): 530. CrossRef
Pulse Wave Velocity in Atherosclerosis
Hack-Lyoung Kim, Sang-Hyun Kim
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Relationships between Cardiac Autonomic Neuropathy and the Brachial-ankle Pulse Wave Velocity in Patients with Type 2 Diabetes.: Young Pil Bae, Byeong Do Yi, Bong Gun Kim, Jong Hwa Park, Yong Seop Kwon, Ja Young Park, Chang Won Lee, Bo Hyun Kim, Jae Sik Jang; Endocrinol Metab. 2011;26(1):44-52. Published online March 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.1.44

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30 Download
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Abstract PDF

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.

Citations

Citations to this article as recorded by

Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus
Jun Ouk Ha, Tae Hee Lee, Chang Won Lee, Ja Young Park, Seong Ho Choi, Hee Seung Park, Jae Seung Lee, Seung Heon Lee, Eun Hee Seo, Young Hwan Kim, Young Woo Kang
Diabetes & Metabolism Journal.2016; 40(4): 297. CrossRef
Relationship between Cardiac Autonomic Neuropathy and Brachial-ankle Pulse Wave Velocity in Type 2 Diabetics
Sin Gon Kim
Endocrinology and Metabolism.2011; 26(1): 33. CrossRef
Determinants for Heart Rate Variability in a Normal Korean Population
Gyung-Mee Kim, Jong-Min Woo
Journal of Korean Medical Science.2011; 26(10): 1293. CrossRef

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