Discriminative value of pulse wave velocity for arterial stiffness and cardiac injury in prediabetic patients

• Published in: Jornal vascular brasileiro Vol. 22; p. e20230076
• Main Authors: Firmino, Stella Maris, Goulart, Cássia da Luz, Gregorio, João Paulo, Wende, Klaus Werner, Yuamoto, Fernanda Yuri, Kummer, Lana, Curcelli, Emílio Martins, Heubel, Alessandro Domingues, Kabbach, Erika Zavaglia, Santos, Polliana Batista, Borghi-Silva, Audrey, Mendes, Renata Gonçalves, Leal, Ângela Mérice de Oliveira, Roscani, Meliza Goi
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 01-01-2023
• Subjects: arterial stiffness; CARDIAC & CARDIOVASCULAR SYSTEMS; carotid-femoral pulse wave velocity; PERIPHERAL VASCULAR DISEASE; prediabetics; risk factors; SURGERY; arterial stiffness; risk factors; prediabetics; carotid-femoral pulse wave velocity; pré-diabéticos; rigidez arterial; velocidade da onda de pulso carotídeo-femoral; fatores de risco
• ISSN: 1677-5449; 1677-7301; 1677-7301
• DOI: 10.1590/1677-5449.202300762

Prediabetes (PD) is defined as impaired fasting glucose and/or impaired glucose tolerance (IGT) and may be associated with high risk of cardiovascular injury. It is recommended that PD patients be screened for signs of arterial stiffness and cardiovascular injury to reinforce therapeutic strategies.
To identify pulse wave velocity values discriminative for arterial stiffness and cardiovascular injury in PD patients.
A cross-sectional study was conducted with PD (N=43) and normoglycemic (N=37) patients who underwent clinical evaluation, arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor, laboratory blood analysis, investigation of morphological and functional cardiac variables by transthoracic echocardiogram, and assessment of carotid intima-media-thickness (CIMT) by carotid ultrasonography. A statistical analysis was performed using SPSS software and values of p<0.05 were considered significant.
A cfPWV cut-off value of 6.9 m/s was identified for IGT (Sensitivity [SE]: 74% and Specificity [SP]: 51%). Comparison of general data and risk factors between subsets with values above and below this cutoff value revealed higher rates of fasting glucose (p=0.02), obesity (p=0.03), dyslipidemia (p=0.004), early signs of left ventricle (p=0.017) and right ventricle (p=0.03) impaired diastolic function, and elevated CIMT in subjects with cfPWV ≥ 6.9m/s (p=0.04).
In PD patients, a cfPWV cutoff of 6.9 m/s was considered a discriminative value for arterial stiffness. These findings highlight the value of early investigation of cardiovascular injury and aggressive therapy strategies with good control of risk factors in PD.