Arterial stiffness, renal function and renal blood flow in patients with coronary artery disease, arterial hypertension and type 2 diabetes mellitus
https://doi.org/10.14341/DM2014396-106
Abstract
To investigate the relationship between changes in indicators of arterial stiffness of various types of vessels, hemodynamic pulsatility, renal function and renal blood flow in patients with coronary artery disease (CAD) and arterial hypertension in the presence or absence of type 2 diabetes mellitus (T2DM).
Materials and Methods.
The study included 96 patients with CAD and arterial hypertension; among them, 54 subjects had T2DM and 42 did not. Сarbohydrate and lipid metabolism, renal function, stiffness of various types of arteries, parameters of hemodynamic pulsatility and renal blood flow were investigated.
Results.
Arterial stiffness of various types of vessels was increased in the T2DM group: carotid?femoral pulse wave velocity as a marker of aortic stiffness (a vessel of the elastic type) was increased by 16% (p <0.001), index ?.
of the common carotid artery (a vessel of the muscular elastic type) was increased by 7.6% (p <0.05) and index ?.
of the brachial artery (a vessel of the muscular type) was increased by 22% (p <0.05). The level of microalbuminuria was 5-fold higher (p <0.05) and the renal resistive index was 12.5% higher (p <0.05) in the diabetics group. Significant correlations were found between aortic stiffness, parameters of hemodynamic pulsatility (pulse pressure, measured at the brachial artery, the central pulse pressure, augmentation index) and renal function and renal blood flow in patients in both groups.
Conclusion.
The results may indicate the general pathogenetic mechanisms and the relationship between the development of increased aortic stiffness and renal dysfunction in patients with CAD, arterial hypertension and T2DM.
About the Authors
Elena Vasilievna OskolaRussian Federation
MD, Research Fellow, Department of Angiology, Myasnikov Clinical Cardiology Institute
Competing Interests:
Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Anna Timofeevna Shubina
Russian Federation
MD, PhD, Research Associate, Department of Angiology, Myasnikov Clinical Cardiology Institute
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Alsu Rafhatovna Zairova
Russian Federation
MD, PhD, Research Associate, Office of innovative diagnostics, Myasnikov Clinical Cardiology Institute
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Marina Vladimirovna Andreevskaya
Russian Federation
MD, Junior Research Associate, Laboratory of ultrasonography, Office of innovative diagnostics, Myasnikov Clinical Cardiology Institute
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Roksana Mirabovna Bogieva
Russian Federation
MD, PhD, Junior Research Associate, Laboratory of ultrasonography, Office of innovative diagnostics, Myasnikov Clinical Cardiology Institute
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Olga Alexandrovna Pogorelova
Russian Federation
MD, PhD, Senior Research Associate, Office of innovative diagnostics, Myasnikov Clinical Cardiology Institute
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Marina Grigorievna Bolotina
Russian Federation
MD, endocrinologist, Myasnikov Clinical Cardiology Institute
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Tatiana Valentinovna Balahonova
Russian Federation
MD, PhD, Professor, Office of innovative diagnostics, Myasnikov Clinical Cardiology Institute
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Anatoliy Nikolaevich Rogoza
Russian Federation
Doctor of biological sciences, Professor, Head of Office of Innovative Diagnostics, Myasnikov Clinical Cardiology Institute
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
Yury Alexandrovich Karpov
Russian Federation
MD, PhD, Professor, Head of Department of Angiology, Myasnikov Clinical Cardiology Institute, associate Director of Cardiology Research Complex
Competing Interests: Авторы декларируют отсутствие конфликта (двойственности) интересов при написании данной рукописи.
References
1. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318-1327. doi: 10.1016/j.jacc.2009.10.061
2. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation. 2002;106(16):2085-2090. doi: 10.1161/01.CIR.0000033824.02722.F7
3. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27(21):2588-2605. doi: 10.1093/eurheartj/ehl254
4. Della-Morte D, Ricordi C, Guadagni F, Rundek T. Measurement of subclinical carotid atherosclerosis may help in predicting risk for stroke in patients with diabetes. Metab Brain Dis. 2013;28(3):337-339. doi: 10.1007/s11011-013-9385-3
5. Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME, London GM. Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension. 1998;32(3):570-574. doi: 10.1161/01.HYP.32.3.570
6. Simons PC, Algra A, Bots ML, Grobbee DE, van der Graaf Y. Common carotid intima-media thickness and arterial stiffness: indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of ARTerial disease). Circulation. 1999;100(9):951-957. doi: 10.1161/01.CIR.100.9.951
7. Cardoso CR, Ferreira MT, Leite NC, Barros PN, Conte PH, Salles GF. Microvascular degenerative complications are associated with increased aortic stiffness in type 2 diabetic patients. Atherosclerosis. 2009;205(2):472-476. doi: 10.1016/j.atherosclerosis.2008.12.027
8. Трунина ЕН, Петунина НА, Чорбинская СА. Ингибиторы дипептидилпептидазы-4 в лечении сахарного диабета 2 типа. Возможности кардиопотекции. Сахарный диабет. 2011;(2):59-64. [Trunina EN, Petunina NA, Chorbinskaya SA. Dipeptidylpeptidase-4 inhibitors in the treatment of diabetes mellitus. Possibilities of cardioprotection. Diabetes mellitus. 2011;(2):59-64.] doi: 10.14341/2072-0351-5636
9. Шестакова МВ, Чугунова ЛА, Шамхалова МШ, Дедов И.И.. Диабетическая нефропатия: достижения в диагностике, профилактике и лечении. Сахарный диабет. 2005; (3):22-25. [Shestakova MV, Chugunova LA, Shamkhalova MS, Dedov II. Diabeticheskaya nefropatiya: dostizheniya v diagnostike,profilaktike i lechenii. Diabetes mellitus. 2005;(3):22-25.] doi: 10.14341/2072-0351-5574
10. Henry RM, Kostense PJ, Bos G, Dekker JM, Nijpels G, Heine RJ, et al. Mild renal insufficiency is associated with increased cardiovascular mortality: The Hoorn Study. Kidney Int. 2002;62(4):1402-1407. doi:10.1111/j.1523-1755.2002.kid571.x
11. Hermans MM, Henry R, Dekker JM, Kooman JP, Kostense PJ, Nijpels G, Heine RJ, Stehouwer CD. Estimated glomerular filtration rate and urinary albumin excretion are independently associated with greater arterial stiffness: the Hoorn Study. J Am Soc Nephrol. 2007;18(6):1942-1952. doi: 10.1681/ASN.2006111217
12. Taniwaki H, Nishizawa Y, Kawagishi T, Ishimura E, Emoto M, Okamura T, et al. Decrease in glomerular filtration rate in Japanese patients with type 2 diabetes is linked to atherosclerosis. Diabetes Care. 1998;21(11):1848-1855. doi: 10.2337/diacare.21.11.1848
13. Takegoshi T, Hirai J, Shimada T, Saga T, Kitoh C. The correlation between pulse wave velocity and diabetic angiopathy. Nihon Ronen Igakkai Zasshi. 1991;28(5):664-667. doi: 10.3143/geriatrics.28.664
14. Schiffrin EL, Lipman ML, Mann JF.Chronic kidney disease: effects on the cardiovascular system. Circulation. 2007;116(1):85-97. doi: 10.1161/CIRCULATIONAHA.106.678342
15. Ahmed N, Thornalley PJ. Роль конечных продуктов гликирования в патогенезе осложнений сахарного диабета. Русский медицинский журнал. 2009;17(9): 642- 650.[ Ahmed N, Thornalley PJ. Rol' konechnykh produktov glikirovaniya v patogeneze oslozhneniy sakharnogo diabeta. Russkiy meditsinskiy zhurnal. 2009;17(9): 642- 650.]
16. Huang K, Huang J, Xie X, Wang S, Chen C, Shen X, et al. Sirt1 resists advanced glycation end products-induced expressions of fibronectin and TGF-β1 by activating the Nrf2/ARE pathway in glomerular mesangial cells. Free Radic Biol Med. 2013;65:528-540. doi: 10.1016/j.freeradbiomed.2013.07.029
17. Raj DS, Choudhury D, Welbourne TC, Levi M. Advanced glycation end products: a Nephrologist's perspective. Am J Kidney Dis. 2000;35(3):365-380. doi: 10.1016/S0272-6386(00)70189-2
18. International Diabetes Federation. Chapter 14: Kidney damage. Global Guideline for Type 2 Diabetes. Clinical Guidelines Task Force. 2005; 54-58. Available from: http://www.idf.org/webdata/docs/GGT2D%2014%20Kidney%20damade.pdf
19. Андреевская МВ, Чихладзе НМ, Саидова МА. Возможности ультразвуковых методов оценки ригидности аорты и ее значимость при патологии сердца и сосудов. Ультразвуковая и функциональная диагностика. 2009;(2):91-97. [Andreevskaya MV, Chikhladze NM, Saidova MA. Aortic Stiffness Ultrasound Assessment in Cardiovascular Pathology. Ulʹtrazvukovai︠a︡ i funkt︠s︡ionalʹnai︠a︡ diagnostika. 2009;(2):91-97.]
20. Рогоза АН, Балахонова ТВ, Чихладзе НМ, и др. Современные методы оценки состояния сосудов у больных артериальной гипертонией. Москва: Атмосфера; 2008.[Rogoza AN, Balakhonova TV, Chikhladze NM, i dr. Sovremennye metody otsenki sostoyaniya sosudov u bol'nykh arterial'noy gipertoniey. Moskva: Atmosfera;2008.]
21. Shirai K, Utino J, Otsuka K, Takata M. A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI). J Atheroscler Thromb. 2006;13(2):101-107. doi: 10.5551/jat.13.101
22. Laurent S, Caviezel B, Beck L, Girerd X, Billaud E, Boutouyrie P, et al. Carotid artery distensibility and distending pressure in hypertensive humans. Hypertension. 1994;23(6 Pt 2):878-883. doi: 10.1161/01.HYP.23.6.878
23. Puttermans T, Nemery C. Diabetes: the use of color Doppler Sonography for the assessment to vascular complications. Eur J Ultrasound. 1998;7(1):15-22. doi: 10.1016/S0929-8266(98)00008-1
24. Cameron JD1, Bulpitt CJ, Pinto ES, Rajkumar C. The aging of elastic and muscular arteries: a comparison of diabetic and nondiabetic subjects. Diabetes Care. 2003;26(7):2133-2138. doi: 10.2337/diacare.26.7.2133
25. Chen Y, Huang Y, Li X, Xu M, Bi Y, Zhang Y, et al. Association of arterial stiffness with HbA1c in 1,000 type 2 diabetic patients with or without hypertension. Endocrine. 2009;36(2):262-267. doi: 10.1007/s12020-009-9221-z
26. Cameron JD, Cruickshank JK. Glucose, insulin, diabetes and mechanisms of arterial dysfunction. Clin Exp Pharmacol Physiol. 2007;34(7):677-682. doi: 10.1111/j.1440-1681.2007.04659.x
27. Authors/Task Force Members, Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J. 2013;34(39):3035-3087. doi: 10.1093/eurheartj/eht108
28. Bartnik M, Rydén L, Ferrari R, Malmberg K, Pyörälä K, Simoons M, et al. The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe. The Euro Heart Survey on diabetes and the heart. Eur Heart J. 2004;25(21):1880-1890. doi: 10.1016/j.ehj.2004.07.027
29. Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation. 2003;107(22):2864-2869. doi: 10.1161/01.CIR.0000069826.36125.B4
30. Chirinos JA, Segers P, Gillebert TC, De Buyzere ML, Van Daele CM, Khan ZA, et al. Central pulse pressure and its hemodynamic determinants in middle-aged adults with impaired fasting glucose and diabetes: the Asklepios study. Diabetes Care. 2013;36(8):2359-2365. doi: 10.2337/dc12-1463
31. Hashimoto J, Ito S. Central pulse pressure and aortic stiffness determine renal hemodynamics: pathophysiological implication for microalbuminuria in hypertension. Hypertension. 2011;58(5):839-846. doi: 10.1161/HYPERTENSIONAHA.111.177469
32. Bruno RM, Daghini E, Landini L, Versari D, Salvati A, Santini E, et al. Dynamic evaluation of renal resistive index in normoalbuminuric patients with newly diagnosed hypertension or type 2 diabetes. Diabetologia. 2011;54(9):2430-2439. doi: 10.1007/s00125-011-2148-y
33. Ohta Y, Fujii K, Arima H, Matsumura K, Tsuchihashi T, Tokumoto M, et al. Increased renal resistive index in atherosclerosis and diabetic nephropathy assessed by Doppler sonography. J Hypertens. 2005;23(10):1905-1911. doi: 10.1097/01.hjh.0000181323.44162.01
34. Bouchi R, Babazono T, Mugishima M, Yoshida N, Nyumura I, Toya K, et al. Arterial stiffness is associated with incident albuminuria and decreased glomerular filtration rate in type 2 diabetic patients. Diabetes Care. 2011;34(12):2570-2575. doi: 10.2337/dc11-1020
35. Hamano K, Nitta A, Ohtake T, Kobayashi S. Associations of renal vascular resistance with albuminuria and other macroangiopathy in type 2 diabetic patients. Diabetes Care. 2008;31(9):1853-1857. doi: 10.2337/dc08-0168
36. Munakata M, Miura Y, Yoshinaga K; J-TOPP study group. Higher brachial-ankle pulse wave velocity as an independent risk factor for future microalbuminuria in patients with essential hypertension: the J-TOPP study. J Hypertens. 2009;27(7):1466-1471. doi: 10.1097/HJH.0b013e32832b4740
37. Taniwaki H, Nishizawa Y, Kawagishi T, Ishimura E, Emoto M, Okamura T, et al. Decrease in glomerular filtration rate in Japanese patients with type 2 diabetes is linked to atherosclerosis. Diabetes Care. 1998;21(11):1848-1855. doi: 10.2337/diacare.21.11.1848
38. Zhan WW, Chen YH, Zhang YF, Zhu Y, Lin YY, Ren XP,et al. Carotid stiffness and microalbuminuria in patients with type 2 diabetes. Endocrine. 2009;35(3):409-413. doi: 10.1007/s12020-009-9172-4
Supplementary files
![]() |
1. Транслитерация статьи | |
Subject | ||
Type | Исследовательские инструменты | |
Download
(49KB)
|
Indexing metadata ▾ |
Review
For citations:
Oskola E.V., Shubina A.T., Zairova A.R., Andreevskaya M.V., Bogieva R.M., Pogorelova O.A., Bolotina M.G., Balahonova T.V., Rogoza A.N., Karpov Yu.A. Arterial stiffness, renal function and renal blood flow in patients with coronary artery disease, arterial hypertension and type 2 diabetes mellitus. Diabetes mellitus. 2014;17(3):96-106. (In Russ.) https://doi.org/10.14341/DM2014396-106

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).