Volume 20, Number 5, 1132-1138, DOI: 10.1007/s00330-009-1655-4Open Access

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Aortic stiffness is associated with cardiac function and cerebral small vessel disease in patients with type 1 diabetes mellitus: assessment by magnetic resonance imaging

Saskia G. C. van Elderen, A. Brandts, J. J. M. Westenberg, J. van der Grond, J. T. Tamsma, M. A. van Buchem, J. A. Romijn, L. J. M. Kroft, J. W. A. Smit and A. de Roos

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Abstract

Objective  

To evaluate, with the use of magnetic resonance imaging (MRI), whether aortic pulse wave velocity (PWV) is associated with cardiac left ventricular (LV) function and mass as well as with cerebral small vessel disease in patients with type 1 diabetes mellitus (DM).

Materials and methods  

We included 86 consecutive type 1 DM patients (49 male, mean age 46.9 ± 11.7 years) in a prospective, cross-sectional study. Exclusion criteria included aortic/heart disease and general MRI contra-indications. MRI of the aorta, heart and brain was performed for assessment of aortic PWV, as a marker of aortic stiffness, systolic LV function and mass, as well as for the presence of cerebral white matter hyperintensities (WMHs), microbleeds and lacunar infarcts. Multivariate linear or logistic regression was performed to analyse the association between aortic PWV and outcome parameters, with covariates defined as age, gender, mean arterial pressure, heart rate, BMI, smoking, DM duration and hypertension.

Results  

Mean aortic PWV was 7.1 ± 2.5 m/s. Aortic PWV was independently associated with LV ejection fraction (ß = -0.406, P = 0.006), LV stroke volume (ß = -0.407, P = 0.001), LV cardiac output (ß = -0.458, P = 0.001), and with cerebral WMHs (P < 0.05). There were no independent associations between aortic stiffness and LV mass, cerebral microbleeds or lacunar infarcts.

Conclusion  

Aortic stiffness is independently associated with systolic LV function and cerebral WMHs in patients with type 1 DM.

Keywords  Aorta - Magnetic resonance imaging - Type 1 diabetes mellitus - Heart - Brain

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