Early stage detection of conduit artery endothelial dysfunction in patients with type 1 diabetes

Abstract

Flow-mediated dilatation evaluation using hand skin heating may possibly be more accurate than post-ischaemic hyperaemia to detect conduit artery endothelial dysfunction in type ' diabetes. We measured in 24 type ' diabetic patients (n=16 without microangiopathy) and 24 healthy matched subjects radial artery diameter (echotracking), blood flow and mean wall shear stress during heating and post-ischaemic hyperaemia. Compared with controls, flow-mediated dilatation was lower in diabetic patients during post-ischaemic hyperaemia and heating. However, in the subgroup of uncomplicated patients, a decreased flow-mediated dilatation was only apparent during heating (I7.l±l.6% vs. 24.3±0.7%, p<0.05) but not during post-ischaemic hyperaemia (10.l±l.l% vs. 10.5±0.6%, NS). This was confirmed by the lower slope of the diameter-mean wall shear stress relationship in these patients in the absence of modification in endothelium- independent dilatation. We conclude that hand skin heating permits the early detection of conduit artery endothelial dysfunction in type ' diabetic patients with normal response to post-ischaemic hyperaemia. This procedure could be useful to investigate the prognostic role of vascular dysfunction and the impact of vasculoprotective treatments in this patient population. © The Author(s) 2010.