Association of left ventricular diastolic function abnormalities with aortic elastic properties in asymptomatic patients with type 2 diabetes mellitus. A tissue doppler echocardiographic study

Background: The aim of this study was to investigate the association between the aortic elastic properties and the left ventricular diastolic function measured by tissue Doppler echocardiography (TDE) in asymptomatic type 2 diabetes mellitus. Methods: Fifty-seven asymptomatic patients with type 2 diabetes (33 women, mean age: 49 ± 6 years) and 25 healthy control subjects (19 women, mean age: 46 ± 7 years) were included in the present study. Diastolic filling indices were measured by conventional (CE) and tissue Doppler echocardiography. The aortic elastic properties [Aortic stiffness index (ASI), aortic distensibility and strain] were measured as previous definition. Results: Compared with control subjects, the ratio of LV diastolic abnormalities measured by CE and TDE were found higher in patients with type 2 diabetes (36% and 73.6%, p = 0.001, respectively, and 52% and 89.4%, p <0.001, for septal annulus; 48% and 89.4%, p <0.001 for septal basal respectively). The ASI was significantly higher (p <0.001), aortic distensibility and aortic strain were also significantly lower in patients with type 2 diabetes than control subjects (p <0.001 and p <0.001 respectively). In the regression analysis, Ao distensibility was correlated to age (β = -0.299, p = 0.004), septal basal Em/Am ratio (β =0.543, p <0.001) and HDL-cholesterol (β = 0.192, p = 0.039). ASI was also correlated only to age (β = 0.255, p = 0.044), the presence of diabetes mellitus (β = 0.304, p = 0.009), mitral A wave (β = 0.322, p = 0.013) and mitral annulus Em wave (β = -0.505, p <0.001). Conclusion: The aortic elastic function is impaired in asymptomatic patients with type 2 diabetes. Increased ASI and decreased Ao distensibility are closely associated with diastolic filling indices measured by CE and TDE.