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Ventricular-Arterial Stiffness and Diastolic Function in Hypertensive Patients with Diabetes
경희대학교 의과대학 순환기내과학교실
손일석, 이재범, 황석재, 김수중, 조진만, 김우식, 김명곤, 김종진, 김권삼, 배종화
Objectives We was to determine that whether the hypertensives with diabetes mellitus(DM) have more increased ventricular-arterial stiffness and more decreased diastolic function than the patients without DM measured by noninvasive method using echocardiography.Methods Having normal left ventricular(LV) ejection fraction, the hypertensives without DM(HTN group, n=200), the hypertensives with DM(HTN with DM group, n=60), and age-,and sex-matched controls(n=20) were enrolled. Echocardiography was performed including LV wall thickness, dimension, and Doppler imaging including transmitral early filling velocity (E), mitral annular early diastolic velocity(E'), and time velocity integral of LV outflow tract flow to calculate stroke volume(SV) and end-diastolic elastance (Ed= E/E’divided by SV). Blood pressure(BP) was measured on supine position before and after echocardiographic examination. Results The hypertensives with or without DM had higher body mass index, BP, and LV mass than the controls. HTN with DM had more increased Ed (0.17±0.05 vs 0.13±0.03, p=0.01) than the controls, had more depressed arterial compliance (SV divided by pulse pressure) (1.51±0.42 vs 1.69±0.52, p<0.05) than HTN. There was no difference in LV function between the hypertensives with and those without DM.Conclusion The hypertensives with DM had more increased ventricular-arterial stiffness than the hypertensives without DM, but diastolic function was not different. DM seems to have additive adverse effects on the ventricular-arterial stiffening in the hypertensives.

 

 

Control (n=20)

HTN (n=200)

HTN with DM (n=60)

LVMI, g/m2

83.8±13.7

112.4±25.8

116.1±32.1

Ed

0.13±0.03

0.16±0.06

0.17±0.05

Arterial compliance (SV/PP)

1.69±0.38

1.69±0.52

1.51±0.42

DT, msec

172.0±20.9

209.9±39.7

214.9±36.9

E’, cm/sec

11.5±2.4

8.4±2.2

7.8±2.1

E/E’ ratio

7.2±1.8

9.0±3.1*

10.0±3.3

Tei index

0.38±0.06

0.45±0.09

0.46±0.1

p<0.01 vs control, *p<0.05 vs control, p<0.05 vs HTN.



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