Abnormal Aortic Distensibility in Well Controlled Diabetes

Abstract

Background:

Diabetes mellitus is strongly associated with cardiovascular disease. Specifically, aortopathy can directly contribute to adverse outcomes in diabetic patients but where the precise mechanism of such disease remains unknown. Cardiac MRI (CMR) provides an opportunity to assess aortopathy by quantitating regional aortic distensibility (AoD).

Aims:

Using CMR at 1.5 T, we compared AoD in individuals with well controlled diabetes and no definite coronary artery disease with healthy controls. Early detection of AoD changes could improve clinical surveillance strategies by identifying individuals with “at risk” phenotype for aortic and vascular complications relating to diabetes.

Methods:

CMR generated cine b-SSFP imaging was acquired in the mid ascending aorta and retrospectively gated throughout the entire cardiac cycle. AoD was then calculated via the following equation.

Aomax – Aomin / Aomin * central pulse pressure in subjects with diabetes attending the RPA Diabetes Centre and matched control subjects. Patient demographics and blood pressure was collected

Results:

Patients with type 2 Diabetes Miletus (T2DM) (n=49, age 59±5years, 63% male, HbA1c 7.4±1.8%, systolic blood pressure 127±9mmHg) had a mean AoD of 2.32±1.34 mmgh-1 * 10-3 compared to controls (n=23, age 57±7, systolic blood pressure 137±13) mean AoD of 4.05 +/- 2.00 mmgh-1 * 10-3 (p=0.046).

Conclusions:

We have demonstrated reduced AoD in well controlled diabetics using CMR. This finding contributes to our understanding of how diabetes leads to the development of aortopathy and warrants longitudinal monitoring for the development of complications.