Left Ventricular Mass in Patients With Type 2 Diabetes Is Independently Associated With Central but not Peripheral Pulse Pressure
- James E. Sharman, PHD12,
- Zhi Y. Fang, PHD1,
- Brian Haluska, PHD1,
- Michael Stowasser, PHD1,
- Johannes B. Prins, PHD1 and
- Thomas H. Marwick, PHD1
- 1University of Queensland Department of Medicine, Princess Alexandra Hospital, Brisbane, Australia
- 2School of Human Movement Studies, Centre for Clinical Research Excellence in Cardiovascular Disease and Metabolic Disorders, Princess Alexandra Hospital, Brisbane, Australia
- Address correspondence and reprint requests to James E. Sharman, PhD, University of Queensland, Department of Medicine, Princess Alexandra Hospital, Ipswich Road, Brisbane, Queensland 4102, Australia. E-mail: jsharman{at}soms.uq.edu.au
An increase in left ventricular mass (LVM) occurs in the presence of type 2 diabetes, apparently independent of hypertension (1), but the determinants of this process are unknown. Brachial blood pressure is not representative of that at the ascending aorta (2) because the pressure wave is amplified from central to peripheral arteries. Central blood pressure is probably more clinically important since local pulsatile pressure determines adverse arterial and myocardial remodeling (3,4). Thus, an inaccurate assessment of the contribution of arterial blood pressure to LVM may occur if only brachial blood pressure is taken into consideration. In this study we sought the contribution of central blood pressure (and other interactive factors known to affect wave reflection, e.g., glycemic control and total arterial compliance) to LVM in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS
The study population comprised 90 type 2 diabetic patients with normal ejection fractions (>50%), no history of coronary artery disease, and normal exercise stress echocardiograms. Patients underwent a standard echocardiographic assessment in which LVM was calculated by Devereux’s formula (5) and indexed to height2.7 (g/m2.7; LVM index [LVMI]). Resting supine brachial blood pressures were recorded in duplicate by sphygmomanometry. Central (ascending aortic) blood pressure and total …
