Impact of the Metabolic Syndrome on Aortic Pulse Pressure and Ascending Aortic Pulsatility in Patients with Angiographically Normal Coronary Arteries

Overview

Journal Can J Cardiol

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2009 Jul 9

PMID 19584971

Citations 3

Authors

Ayse Emre

Dilaver Oz

Kemal Yesilcimen

Nurten Sayar

Dilek Ergun

Affiliations

Soon will be listed here.

Abstract

Background: Large artery stiffness is a major determinant of pulse pressure (PP), and PP at baseline has been associated with future coronary events.

Objective: To evaluate the impact of the metabolic syndrome on aortic PP and ascending aortic pulsatility (AP) in patients with angiographically normal coronary arteries.

Methods: Forty-two patients with the metabolic syndrome and 40 age matched control subjects without the metabolic syndrome were included in the study. All subjects had normal coronary arteries. Diagnosis of the metabolic syndrome was based on the International Diabetes Federation guidelines published in 2005. Ascending AP was estimated as the ratio of aortic PP to mean blood pressure.

Results: Aortic PP (59+/-12 mmHg versus 43+/-10 mmHg; P<0.001) and ascending AP (0.54+/-0.10 versus 0.48+/-0.10; P<0.001) were significantly higher in the metabolic syndrome group. Multiple regression analysis revealed statistically independent relationships between ascending AP and fasting blood glucose, waist circumference and systolic blood pressure (model R2=0.408; P<0.001). The metabolic syndrome, as a whole, was also independently associated with both ascending AP (P<0.01) and aortic PP (P<0.01).

Conclusion: The data showed that the metabolic syndrome is independently associated with increased aortic PP and ascending AP in patients with normal coronary arteries, suggesting aortic stiffness as one of the possible mechanisms underlying the excess cardiovascular risk associated with the metabolic syndrome.

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References

Laurent S . Arterial wall hypertrophy and stiffness in essential hypertensive patients. Hypertension. 1995; 26(2):355-62. DOI: 10.1161/01.hyp.26.2.355. View

Jesmin S, Sakuma I, Hattori Y, Kitabatake A . Role of angiotensin II in altered expression of molecules responsible for coronary matrix remodeling in insulin-resistant diabetic rats. Arterioscler Thromb Vasc Biol. 2003; 23(11):2021-6. DOI: 10.1161/01.ATV.0000094235.78783.D1. View

Wilson P, Kannel W, Silbershatz H, DAgostino R . Clustering of metabolic factors and coronary heart disease. Arch Intern Med. 1999; 159(10):1104-9. DOI: 10.1001/archinte.159.10.1104. View

. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997; 20(7):1183-97. DOI: 10.2337/diacare.20.7.1183. View

Grundy S . Hypertriglyceridemia, insulin resistance, and the metabolic syndrome. Am J Cardiol. 1999; 83(9B):25F-29F. DOI: 10.1016/s0002-9149(99)00211-8. View

Rizzoni D, Porteri E, Guelfi D, Muiesan M, Valentini U, Cimino A . Structural alterations in subcutaneous small arteries of normotensive and hypertensive patients with non-insulin-dependent diabetes mellitus. Circulation. 2001; 103(9):1238-44. DOI: 10.1161/01.cir.103.9.1238. View

FRIEDEWALD W, Levy R, Fredrickson D . Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6):499-502. View

Singhal A, Farooqi I, Cole T, ORahilly S, Fewtrell M, Kattenhorn M . Influence of leptin on arterial distensibility: a novel link between obesity and cardiovascular disease?. Circulation. 2002; 106(15):1919-24. DOI: 10.1161/01.cir.0000033219.24717.52. View

Nakayama Y, Tsumura K, Yamashita N, Yoshimaru K, Hayashi T . Pulsatility of ascending aortic pressure waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty. Circulation. 2000; 101(5):470-2. DOI: 10.1161/01.cir.101.5.470. View

10.

Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L . Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001; 37(5):1236-41. DOI: 10.1161/01.hyp.37.5.1236. View

11.

van Popele N, Westendorp I, Bots M, Reneman R, Hoeks A, Hofman A . Variables of the insulin resistance syndrome are associated with reduced arterial distensibility in healthy non-diabetic middle-aged women. Diabetologia. 2000; 43(5):665-72. DOI: 10.1007/s001250051356. View

12.

Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D . Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet. 2001; 358(9291):1400-4. DOI: 10.1016/S0140-6736(01)06525-4. View

13.

Ford E . The metabolic syndrome and mortality from cardiovascular disease and all-causes: findings from the National Health and Nutrition Examination Survey II Mortality Study. Atherosclerosis. 2004; 173(2):309-14. DOI: 10.1016/j.atherosclerosis.2003.12.022. View

14.

Airaksinen K, Salmela P, Linnaluoto M, Ikaheimo M, Ahola K, Ryhanen L . Diminished arterial elasticity in diabetes: association with fluorescent advanced glycosylation end products in collagen. Cardiovasc Res. 1993; 27(6):942-5. DOI: 10.1093/cvr/27.6.942. View

15.

Ciccone M, Vettor R, Pannacciulli N, Minenna A, Bellacicco M, Rizzon P . Plasma leptin is independently associated with the intima-media thickness of the common carotid artery. Int J Obes Relat Metab Disord. 2001; 25(6):805-10. DOI: 10.1038/sj.ijo.0801623. View

16.

Liao D, Arnett D, Tyroler H, RILEY W, Chambless L, Szklo M . Arterial stiffness and the development of hypertension. The ARIC study. Hypertension. 1999; 34(2):201-6. DOI: 10.1161/01.hyp.34.2.201. View

17.

Schillaci G, Pirro M, Vaudo G, Mannarino M, Savarese G, Pucci G . Metabolic syndrome is associated with aortic stiffness in untreated essential hypertension. Hypertension. 2005; 45(6):1078-82. DOI: 10.1161/01.HYP.0000165313.84007.7d. View

18.

Smulyan H, Siddiqui D, Carlson R, London G, Safar M . Clinical utility of aortic pulses and pressures calculated from applanated radial-artery pulses. Hypertension. 2003; 42(2):150-5. DOI: 10.1161/01.HYP.0000084051.34269.A9. View

19.

Nakayama Y, Nakanishi N, Sugimachi M, Takaki H, Kyotani S, Satoh T . Characteristics of pulmonary artery pressure waveform for differential diagnosis of chronic pulmonary thromboembolism and primary pulmonary hypertension. J Am Coll Cardiol. 1997; 29(6):1311-6. DOI: 10.1016/s0735-1097(97)00054-5. View

20.

Alberti K, Zimmet P, Shaw J . The metabolic syndrome--a new worldwide definition. Lancet. 2005; 366(9491):1059-62. DOI: 10.1016/S0140-6736(05)67402-8. View