P2.31 Aortic Stiffness is an Independent Predictor of Mildly Elevated Diastolic Blood Pressure in Young Patients with Well Controlled, Early Onset, Type 1 Diabetes

Abstract

Background

few data are available on cardiovascular (CV) involvement in young DM1 subjects with disease onset in pediatric age.

Aim

to assess preclinical CV changes in young patients with early onset DM1.

Methods

Thirty DM1 normotensive subjects (age = 19.4±3.2 years, BMI = 22.1±2.7 kg/m², disease duration = 10.7±5.4 years, HbA1c = 7.8±1.4%) without macro- and microvascular complications, and 14 controls (C) of comparable age and BMI. Common carotid artery (CCA) IMT, local stiffness (ß and Ep) and wave speed (WS) were obtained by echo-tracking (Aloka Alpha10). Aortic stiffness was assessed by carotid-femoral pulse wave velocity (PWV). Myocardial tissue velocities, LV geometry and function were evaluated by echocardiography.

Results

DM1 had, compared to C, higher (p<0.05) diastolic BP (DBP: 68±7 vs 62±4 mmHg), interventricular septum thickness (IVS) (0.76±0.11 vs 0.65±0.10 cm) and LV relative wall thickness (RWT: 0.31±0.4 vs 0.28±0.03). No differences between groups were found for pulse pressure, LV mass index, midwall shortening, transmitral E/A, myocardial velocities, CCA IMT and stiffness, WS and PWV. In the entire population, DBP increased with age, BMI, WS and PWV (r from 0.33 to 0.38, p < 0.05), and IVS increased with SBP and BMI (r = 0.35 and 0.49, p<0.05). Independent predictors of DBP were WS and DM1 (R2 = 0.23, p<0.005), whereas predictors of IVS were sex, BMI and DM1 (R2 = 0.53, p<0.0001). RWT was independently related to DM1 (R² = 0.12, p<0.05).

Conclusions

well controlled young DM1 subjects show mildly elevated DBP and a trend towards LV concentric remodelling. Whether arterial stiffness is mechanism or result of increased DBP remains to be established.