Pulse pressure and cardiovascular autonomic neuropathy according to duration of type 1 diabetes.

in Diabetes/Metabolism Research & Reviews (2009)

BACKGROUND: To evaluate changes in pulse pressure (PP) and markers of cardiovascular autonomic neuropathy (CAN) according to duration of type 1 diabetes mellitus (T1DM). METHODS: This cross-sectional ... [more ▼]

BACKGROUND: To evaluate changes in pulse pressure (PP) and markers of cardiovascular autonomic neuropathy (CAN) according to duration of type 1 diabetes mellitus (T1DM). METHODS: This cross-sectional controlled study evaluated 159 diabetic patients during a 3-min posture test (standing-squatting-standing) with continuous measurement of systolic (SBP), diastolic (DBP) and mean (MBP) blood pressure by a Finapres device. Arterial stiffness was indirectly assessed by PP and the slope of PP as a function of MBP calculated during the whole 3-min test. CAN was assessed by the expiration/inspiration pulse interval ratio (E/I R-R ratio) during deep breathing and by three indices measured during the squatting test. Patients were divided into four groups according to diabetes duration (<10 years, 11-20 years, 21-30 years and > 30 years from group 1 to group 4, respectively) and compared with age-matched non-diabetic subjects. RESULTS: PP progressively increased (p < 0.0001) and PP/MBP decreased (p < 0.0005) according to T1DM duration, whereas these parameters remained almost unchanged in age-matched control subjects. E/I ratio (p < 0.0001) and baroreflex gain (p < 0.0005) progressively decreased with T1DM duration. The parasympathetic index (squatting test vagal ratio-SqTv) significantly increased (p < 0.0001), whereas the sympathetic index (squatting test sympathetic ratio-SqTs) only tended to decrease (p = 0.12) according to diabetes duration. No such changes in CAN indices were observed in the non-diabetic population. CONCLUSIONS: PP increased according to T1DM duration in an age range where PP remained almost stable in controls, in agreement with accelerated arterial stiffening due to chronic hyperglycaemia. The baroreflex gain decreased and other indices of CAN also deteriorated with diabetes duration, more so indices reflecting parasympathetic rather than sympathetic dysfunction. [less ▲]

Squatting amplifies pulse pressure increase with disease duration in patients with type 1 diabetes.

in Diabetes Care (2008), 31(2), 322-4

OBJECTIVE: To evaluate pulse pressure changes according to duration of type 1 diabetes and to assess the influence of posture. RESEARCH DESIGN AND METHODS: We performed continuous measurement of blood ... [more ▼]

OBJECTIVE: To evaluate pulse pressure changes according to duration of type 1 diabetes and to assess the influence of posture. RESEARCH DESIGN AND METHODS: We performed continuous measurement of blood pressure with a Finapres device during a 3 x 1 min posture test (standing, squatting, standing) in 159 type 1 diabetic patients divided into four groups according to diabetes duration (<or=10, 11-20, 21-30, and >30 years, groups 1-4, respectively) and compared the results with those of age-matched nondiabetic subjects. RESULTS: Pulse pressure progressively increased according to type 1 diabetes duration (P < 0.0001), especially in women, but not in age-matched nondiabetic subjects (NS). Pulse-pressure increase from group 1 to group 4 was amplified in the squatting position (from 50 +/- 17 to 69 +/- 14 mmHg) compared with standing (from 44 +/- 15 to 55 +/- 12 mmHg). CONCLUSIONS: Pulse pressure increases according to type 1 diabetes duration more in women than in men, and the squatting position sensitizes such pulse-pressure increase in both sexes. [less ▲]

Physiological consequences of strenuous concentric and eccentric isokinetic exercises

in Isokinetics & Exercise Science (2007), 15(1), 51

Metabolic and cardiovascular consequences of strenuous concentric versus eccentric isokinetic exercise

in Abstract Book “Exercise and muscle physiology” de l’Ecole Doctorale en Sciences de la Motricité (2006)

Effets de la durée du diabète de type 1 sur la pression artérielle pulsée : résultats d’une étude transversale comparative à un groupe contrôle non diabétique.

in Archives des Maladies du Coeur et des Vaisseaux (2005), 98(suppl), 7010

La neuropathie autonome cardiaque diabetique.

in Revue Médicale de Liège (2005), 60(5-6), 498-504

Cardiac autonomic neuropathy (CAN) is a common complication of diabetes mellitus, which is associated with a higher risk of morbidity and mortality. It can be detected by analyzing spontaneous (Holter) or ... [more ▼]

Cardiac autonomic neuropathy (CAN) is a common complication of diabetes mellitus, which is associated with a higher risk of morbidity and mortality. It can be detected by analyzing spontaneous (Holter) or provoked (Ewing's test battery) changes in heart rate and arterial blood pressure. Baroreflex gain is a specific index of great interest. Our laboratory has acquired a large experience in the assessment of CAN in diabetic patients. We use the Finapres, a device that allows continuous noninvasive monitoring of blood pressure and heart rate, and a special and discriminative active orthostatic manoeuvre, the "squatting" test (standing-squatting-standing). [less ▲]

Influence du contrôle glycémique sur l’évolution de la pression artérielle pulsée chez le patient diabétique de type 1 : premiers résultats d’une étude longitudinale.

in Archives des Maladies du Coeur et des Vaisseaux (2004), 97(suppl), 252

La microalbuminurie du patient diabétique de type 1 n'est pas associée à une augmentation de la pression artérielle moyenne ou pulsée, mais à une hypertension relative en position accroupie

in Archives des Maladies du Coeur et des Vaisseaux (2003), 96(sup. 2), 32

L'image du mois. L'hypotension orthostatique filmee par le Finapres: neuropathie autonome versus cause iatrogene.

in Revue Médicale de Liège (2001), 56(3), 133-4

L'image du mois. Perte de l'arythmie sinusale respiratoire dans la neuropathie autonome diabetique.

in Revue Médicale de Liège (2001), 56(10), 669-70