NDLI: P4.14 Exercise Aortic Reservoir Function in Patients with Type 2 Diabetes is Associated with Brain Atrophy

Content Provider	Springer Nature : BioMed Central
Author	Climie, R. E. Srikanth, V. Beare, R. Keith, L. J. Davies, J. E. Sharman, J. E.
Abstract	Objectives Vascular mechanisms underlying brain atrophy and white matter lesions (WML) in patients with type 2 diabetes (T2DM) are unknown. Increased exercising blood pressure (BP) is associated with end-organ damage and could explain these brain abnormalities. This study examined associations between exercise central haemodynamics and brain structure. Methods Forty healthy participants (53±9 years; 50% male) and 40 T2DM (62±9 years; 50% male) were examined at rest and during light exercise. Resting and exercise central haemodynamics, including systolic BP (SBP), pulse pressure (PP) augmented pressure (AP), augmentation index (AIx), aortic stiffness and aortic reservoir function (including excess pressure integral [xsP]) were recorded by tonometry. Segmented grey (GM) and white matter (WM) and WML volumes were derived from magnetic resonance imaging. Results T2DM participants had lower WM (p=0.004) and GM (p=0.07) volumes, and significant elevation of all central hemodynamic variables during exercise (p<0.01 all). At rest, greater central (not brachial) haemodynamics (SBP, AP, AIx and PP) were independently associated with greater WML volume (β=0.54, p=0.031, β=0.55, p=0.01; β=0.46, p=0.046 and; p=0.48, p=0.01, respectively) in controls (not T2DM). During exercise, increased xsP was independently associated with reduced WM (β =-0.54, p=0.006) and GM (β=-0.63, p=0.013) volumes only in T2DM independent of age, sex, heart rate, and 24-hour ambulatory SBP. Conclusions In T2DM, aortic reservoir function and transmission of excess pressure during exercise is associated with brain atrophy. These findings suggest that vascular mechanisms underlying structural brain changes may differ between healthy individuals and those with T2DM. Variable (mean±SD) Regression Coefficient 95% CI Beta Coefficient P value R2 PWV (6.12±1.53 m/s) -3.619 -5.0, -2.2 -0,503 <0,0001 0,25 HR (64.2±9.4 bpm) -0.426 -0.6, -0.2 -0,344 <0,0001 0,14 Sex (male) -4.373 -8.4, -0.3 -0,212 0,029 0,04 Age (48±11 yrs) -0.187 -0.7, 0,3 -0.187 0,547 - MAP (97.9±8.8 mmHg) -0.019 -0.4, 0.2 -0.077 0,759 - R-Squared for the model including only significant variables (PWV, sex, HR) 0,342 Predictors of cardiac BRS (Multiple linear regression analysis)
Related Links	https://arteryresearch.biomedcentral.com/counter/pdf/10.1016/j.artres.2012.09.162.pdf
Ending Page	187
Page Count	1
Starting Page	187
File Format	HTM / HTML
ISSN	18764401
DOI	10.1016/j.artres.2012.09.162
Journal	Artery Research
Issue Number	4
Volume Number	6
Language	English
Publisher	BioMed Central
Publisher Date	2012-11-17
Access Restriction	Open
Subject Keyword	Medicine Public Health Medicine/Public Health
Content Type	Text
Resource Type	Synopsis
Subject	Physiology (medical) Physiology
Journal Impact Factor	0.9/2023
5-Year Journal Impact Factor	0.7/2023

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P4.14 Exercise Aortic Reservoir Function in Patients with Type 2 Diabetes is Associated with Brain Atrophy

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