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Title: Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes.
Austin Authors: MacIsaac, Richard J;Thomas, Merlin C;Panagiotopoulos, Sianna ;Smith, Trudy J;Hao, Huming ;Matthews, D Geoffrey;Jerums, George ;Burrell, Louise M ;Srivastava, Piyush M 
Affiliation: Endocrine Centre, Austin Health & University of Melbourne, Melbourne, Australia
Issue Date: 23-May-2008
Publication information: Cardiovascular Diabetology 2008; 7: 15
Abstract: In comparison to the well established changes in compliance that occur at the large vessel level in diabetes, much less is known about the changes in compliance of the cardiovascular system at the end-organ level. The aim of this study was therefore to examine whether there was a correlation between resistance of the intrarenal arteries of the kidney and compliance of the left ventricle, as estimated by measurements of diastolic function, in subjects with type 2 diabetes.We studied 167 unselected clinic patients with type 2 diabetes with a kidney duplex scan to estimate intrarenal vascular resistance, i.e. the resistance index (RI = peak systolic velocity-minimum diastolic velocity/peak systolic velocity) and a transthoracic echocardiogram (TTE) employing tissue doppler studies to document diastolic and systolic ventricular function.Renal RI was significantly higher in subjects with diastolic dysfunction (0.72 +/- 0.05) when compared with those who had a normal TTE examination (0.66 +/- 0.06, p < 0.01). Renal RI values were correlated with markers of diastolic dysfunction including the E/Vp ratio (r = 0.41, p < 0.001), left atrial area (r = 0.36, p < 0.001), the E/A ratio (r = 0.36, p < 0.001) and the E/E' ratio (r = 0.31, p < 0.001). These associations were independent of systolic function, hypertension, the presence and severity of chronic kidney disease, the use of renin-angiotensin inhibitors and other potentially confounding variables.Increasing vascular resistance of the intrarenal arteries was associated with markers of diastolic dysfunction in subjects with type 2 diabetes. These findings are consistent with the hypothesis that vascular and cardiac stiffening in diabetes are manifestations of common pathophysiological mechanisms.
Gov't Doc #: 18500986
DOI: 10.1186/1475-2840-7-15
ORCID: 0000-0003-1863-7539
Type: Journal Article
Subjects: Adult
Diabetes Mellitus, Type 2.complications.physiopathology
Diabetic Angiopathies.physiopathology
Kidney.blood supply
Middle Aged
Renal Artery.physiology
Vascular Resistance.physiology
Ventricular Dysfunction, Left.physiopathology.ultrasonography
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