Doppler echocardiographic assessment of aortic stiffness and myocardial performance index in insulin dependent diabetics

ABSTRACT

Type I diabetes is characterized by diffuse arterial wall stiffening and thickening which progress with the severity of the disease but could be detected also in the absence of any diabetic-related complications. The stiffening of aorta and other central arteries is a potential risk factor for increased cardiovascular morbidity and mortality. In this study, we aimed to assess the aortic stiffness index, aortic strain, aortic pulse wave velocity [PWV] and myocardial performance index [MPI] in insulin dependent diabetic children and adolescents non invasively using Doppler echocardiography, correlating it with disease duration, state of glycemic control, and lipid profile. Thirty normotensive insulin dependent diabetics and 33 healthy control group were studied. 2D, M-mode and Doppler echocardiography was performed. Calculation of aortic strain, aortic stiffness index and MPI were done. Measurement of glycosylated hemoglobin [HbA1c] and microalbuminuria were performed. The results proved that the aortic stiffness index and aortic strain were significantly higher in diabetics than in the control group [p=0.02] and [p=0.001] respectively. Aortic strain correlated positively with HbA1c [p=0.05, r=0.4]. Aortic PWV and MPI were significantly higher in the cases [p=0.0001] and [p=0.003] respectively