Endocrinology and Metabolism

Jae Sik Jang (Jang JS)

2 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

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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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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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