Arterial stiffness, renal function and renal blood flow in patients with coronary artery disease, arterial hypertension and type 2 diabetes mellitus
Aim. To investigate the relationship between changes in indicators of arterial stiffness of various types of vessels, hemodynamic pulsatility, renal function and renal blood flow in patients with coronary artery disease (CAD) and arterial hypertension in the presence or absence of type 2 diabetes mellitus (T2DM). Materials and Methods. The study included 96 patients with CAD and arterial hypertension; among them, 54 subjects had T2DM and 42 did not. Сarbohydrate and lipid metabolism, renal function, stiffness of various types of arteries, parameters of hemodynamic pulsatility and renal blood flow were investigated. Results. Arterial stiffness of various types of vessels was increased in the type 2 diabetes group: carotid-femoral pulse wave velocity as a marker of aortic stiffness (a vessel of the elastic type) was increased by 16% (p <0.001), index β of the common carotid artery (a vessel of the muscular elastic type) was increased by 7.6% (p <0.05) and index β of the brachial artery (a vessel of the muscular type) was increased by 22% (p <0.05). The level of microalbuminuria was 5-fold higher (p <0.05) and the renal resistive index was 12.5% higher (p <0.05) in the diabetics group. Significant correlations were found between aortic stiffness, parameters of hemodynamic pulsatility (pulse pressure, measured at the brachial artery, the central pulse pressure, augmentation index) and renal function and renal blood flow in patients in both groups. Conclusion. The results may indicate the general pathogenetic mechanisms and the relationship between the development of increased aortic stiffness and renal dysfunction in patients with CAD, arterial hypertension and T2DM.