Assessment of Subclinical Atherosclerosis with Aortic Velocity Propagation in Patients with Type 2 Diabetes and Chronic Kidney Disease

Abstract

Introduction: Diabetes mellitus (DM) and chronic kidney disease (CKD) accelerate the process of atherosclerosis. To improve clinical outcomes, non-invasive imaging modalities have been proposed to measure and monitor atherosclerosis. Recently, colour M-mode-derived propagation velocity of the descending thoracic aorta [aortic velocity propagation (AVP)] has been shown to be associated with coronary and carotid atherosclerosis. Patients and Methods: The study population included 90 patients with type 2 diabetes who had CKD (Group 1) and 40 age- and sex-matched patients with type 2 diabetes who had a normal renal function (Group 2). Carotid intima-media thickness (CIMT) and AVP were measured. Patients with known coronary heart disease or end-stage renal disease were excluded. Results: Compared with Group 1, patients in Group 2 had significantly lower AVP (Group 1= 29.85 ± 3.95 cm/s and Group 2= 41.05 ± 3.34 cm/s, p< 0.001) and higher CIMT (Group 1= 1.06 ± 0.11 mm and Group 2= 0.78 ± 0.10 mm, p< 0.001). There were significant correlations between AVP and CIMT (r= -0.669, p< 0.001). Conclusion: Patients with diabetes who have CKD exhibit more subclinical atherosclerosis, which is determined by more prominent AVP and CMIT, than patients with diabetes who have a normal renal function. These simple methods might improve patient selection for the prevention of primary atherosclerotic progression.