Portal de Periódicos da CAPES

P673Improvement of arterial stiffness and myocardial deformation in patients with poorly controlled diabetes mellitus type 2 after optimization of antidiabetic medicationP674Clinical presentation, echocardiographic findings and complications in patients with typical and atypical form of takotsubo cardiomyopathyP675Left ventricular mass/end-diastolic volume ratio with tridimensional echocardiography in newly-diagnosed hypertensive patients: which relation between left ventricular geometry and …

2016; Oxford University Press; Volume: 17; Issue: suppl 2 Linguagem: Inglês

10.1093/ehjci/jew250.002

2047-2412

Ignatios Ikonomidis, Monika Budnik, M. Lembo, A-M Vintila, Tomáš Jurko, F Ciciarello, D. Mihalcea, Flavio D’Ascenzi, Marcin Konopka, M. Deljanin Ilic, O. Vriz, AT. Timoteo, M. Bieseviciene, Matteo Cameli, Quirino Ciampi, Clara Carpeggiani, Caroline M. Van De Heyning, H. Zainal Abidin, L. Pratali, Madalena Coutinho Cruz, S. Stoebe, Jhonatan Augusto Ribeiro, G Perea, О.В. Терешина, George Pavlidis, Vaia Lambadiari, Foteini Kousathana, Helen Triantafyllidi, Mary Varoudi, Dimitrios Vlastos, S. Vlachos, Georgios Dimitriadis, J. Lekakis, Janusz Kochanowski, Radosław Piątkowski, Karolina Wojtera, Grzegorz Opolski, F. Lo Iudice, R. Esposito, C. Santoro, Davide Gerardi, Giovanni de Simone, Bruno Trimarco, M. Galderisi, V. Vintila, I Bruckner, AJR Jurko, A Jurko, Michal Mestanik, Andrea Mestanikova, Ingrid Tonhajzerová, VS. Valeria Silvestri, RB. Roberto Badagliacca, DV. Dario Vizza, F Fedele, L Agati, Maria Florescu, AM. Vladareanu, Dragoş Vinereanu, Marco Solari, BM. Natali, Angela Malandrino, Federica Valentini, Matteo Cameli, Marta Focardi, Marco Bonifazi, Antonio Pelliccia, Sergio Mondillo, Krystyna Burkhard-Jagodzińska, Agnieszka Jakubiak, W Król, Andrzej Klusiewicz, Ryszard Zdanowicz, Dariusz Sitkowski, Mirosław Dłużniewski, Wojciech Braksator, Dejan Petrović, S. Stojanović, Stevan Ilić, Gordana Kocić, Mario Pirisi, J. Magné, Victor Aboyans, Rosalba Minisini, E. Bossone, L. Moura Branco, SA. Rosa, A. Galrinho, L. Sousa, JA. Oliveira, A. Agapito, RC. Ferreira, V. Mizariene, JJ. Vaskelyte, V. Lesauskaite, Ramunė Šepetienė, GE Mandoli, Daniele Menci, Erminio Capitani, C. Albizzi, Felice Crudele, Flavio D’Ascenzi, Marta Focardi, Sergio Mondillo, Rodolfo Citro, Sergio Severino, Graziana Labanti, Lauro Cortigiani, Rosa Sicari, Maurizio Galderisi, E. Bossone, Paolo Colonna, Eugenio Picaño, Pablo Landi, C. Michelassi, Rosa Sicari, Eugenio Picaño, Bert Ectors, Hilde Heuten, Bharati Shivalkar, J.R. Ismail, Sazzli Kasim, G. Giardini, Marco Cavana, Eugenio Picaño, Rita Ilhão Moreira, L. Moura Branco, A. Galrinho, Luís Miranda, AT. Timoteo, J. Abreu, P. Modas Daniel, J. Fragata, R. Cruz Ferreira, G. Farese, A. Tarr, D. Jurisch, D. Pfeiffer, A. Hagendorff, R. Teixeira, L. Puga, Manoel da Cunha Costa, Jorge Miguel Silva, Luís Paiva, Lino Gonçalves, M. Lombardero, Ruth Henquin, Carlos Izurieta, MC. Corneli,

Cardiovascular Function and Risk Factors

Background: Arterial stiffness is associated with increased risk for cardiovascular disease. The purpose of this study is to investigate the arterial stiffness and myocardial deformation in patients with poorly controlled diabetes mellitus type 2 before and after glycemic control by optimal medication. Methods: In 50 patients with uncontrolled type 2 diabetes(age:52±10years)and 25 controls of similar age and sex and no atherosclerotic risk factors we measured at baseline and 6 months after glycemic control a) carotid-femoral pulse wave velocity(PWVc m/sec-Complior SP ALAM),central systolic blood pressure(cSBP -mmHg),augmentation index(AI%), of the aortic pulse wave(ArteriographTensioMed) b)S’,E’(m/sec)andE’/A’of mitral annulus by Tissue Doppler c)LV longitudinal strain(GLS-%),systolic(LongSr-l/sec)and diastolic(LongSrE-l/sec)strain rate, twisting(Tw-deg),peak twisting(Tw)and untwisting(unTw-deg/sec)velocity using speckle tracking echocardiography.The degree of LV untwisting was calculated as the percentage difference between peak twisting and untwisting at MVO(%dp PeakTw−UntwMVO)and between peak twisting and untwisting at peak and end of the mitral inflow E wave d)perfusion boundary region(PBR- micrometers)of the sublingual arterial microvessels(ranged from 5-25 micrometers)using Sideview,Darkfield imaging(Microscan,Glycocheck).Increased PBR is considered an accurate index of reduced endothelial glucocalyx thickness because of a deeper RBC penetration in the glucocalyx e) Flow mediated dilatation(FMD) of the brachial artery and percentage difference of FMD (FMD%). Results: Compared to controls,diabetics had higher PWVa(10.3±2.2 vs. 8.1±1.9), AI(27.9±15 vs. 19.4±14.7), PWVc(11.8±3.2 vs. 8.8±1.3),cSBP(136±20 vs. 119±18),PBR (2.1±0.2 vs 1.89±0.1)and lower GLS(-15±3 vs. -18±3),LongSr(-0.78±0.1 vs. -0.96±0.2),LongSrE(0.77±0.29 vs. 1.2±0.3),S’,E’ and E/A(p<0.05 for all comparisons). Baseline FMD was related with Untw at peak E%(r=0,65, p<0.05). Six months after the modification of antidiabetic medication all patients achieved glycaemic control and there was a reduction of PWVc(12.3±2.9 vs. 11.3±3.2,p<0.05) in parallel with a increase of Untw velocity (-73±27 vs. -98±43,p<0.05),Untw MVO%(20±9 vs. 30±2),Untw peak E% (40±14 vs. 50±16)and FMD%(7.8±3 vs. 13.6±11,p<0.01).Reduced PWVc was related with reduced SBP(r=0.62),cSBP(r=0.55)and increased LongsrE(r=-0.50), Untw at end E(r=-0.56)respectively(p<0.05 for all associations). Conclusion: Glycaemic control after optimizing medical treatment improves arterial stiffness, LV myocardial strain, twisting and untwisting velocity in diabetics.