Key result
A 1 m/s increase in baseline carotid-femoral pulse wave velocity was associated with a 16% increase in cerebral white matter hyperintensity volume over 5 years.
Why the study?
Stroke is a serious complication in type 2 diabetes, and arterial stiffness may improve stroke prediction.
Does increased arterial stiffness (measured by pulse wave velocity) predict the progression of cerebral white matter hyperintensities in patients with type 2 diabetes and matched controls?
Cohort (n=104)
No
Does increased arterial stiffness (measured by pulse wave velocity) predict the progression of cerebral white matter hyperintensities in patients with type 2 diabetes and matched controls?
Effect estimate: 16% increase per 1 m/s increase (95% CI 1-32)
p-value: p=<0.05
Higher baseline arterial stiffness, measured by pulse wave velocity, independently predicts the progression of cerebral white matter hyperintensities over 5 years in both patients with type 2 diabetes and healthy controls.
May identify higher-risk patients for cerebral small vessel disease progression; hypothesis-generating and requires prospective trials before clinical adoption.
BACKGROUND: Stroke is a serious complication in patients with type 2 diabetes (T2DM). Arterial stiffness may improve stroke prediction. We investigated the association between carotid-femoral pulse wave velocity [PWV] and the progression of cerebral white matter hyperintensities (WMH), a marker of stroke risk, in patients with T2DM and controls. METHODS: In a 5-year cohort study, data from 45 patients and 59 non-diabetic controls were available for analysis. At baseline, participants had a mean (± SD) age of 59 ± 10 years and patients had a median (range) diabetes duration of 1.8 (0.8-3.2) years. PWV was obtained by tonometry and WMH volume by an automated segmentation algorithm based on cerebral T2-FLAIR and T1 MRI (corrected by intracranial volume, cWMH). High PWV was defined above 8.94 m/s (corresponding to the reference of high PWV above 10 m/s using the standardized path length method). RESULTS: Patients with T2DM had a higher PWV than controls (8.8 ± 2.2 vs. 7.9 ± 1.4 m/s, p < 0.01). WMH progression were similar in the two groups (p = 0.5). One m/s increase in baseline PWV was associated with a 16% [95% CI 1-32%], p < 0.05) increase in cWMH volume at 5 years follow-up after adjustment for age, sex, diabetes, pulse pressure and smoking. High PWV was associated with cWMH progression in the combined cohort (p < 0.05). We found no interaction between diabetes and PWV on cWMH progression. CONCLUSIONS: PWV is associated with cWMH progression in patients with type 2 diabetes and non-diabetic controls. Our results indicate that arterial stiffness may be involved early in the pathophysiology leading to cerebrovascular diseases.
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Funck et al. (2021) conducted a cohort in Type 2 diabetes and cerebral white matter hyperintensities (n=104). Carotid-femoral pulse wave velocity (PWV) vs. Lower PWV was evaluated on Progression of cerebral white matter hyperintensities (cWMH) volume (16% increase per 1 m/s increase, 95% CI 1-32, p=<0.05). A 1 m/s increase in baseline carotid-femoral pulse wave velocity was associated with a 16% increase in cerebral white matter hyperintensity volume over 5 years.
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