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Reflection index predicts vascular damage in diabetes, high CVD risk
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BOSTON — In patients with diabetes and high CVD risk, measuring change in reflection index noninvasively predicted endothelial dysfunction, according to a poster presented at the Cardiometabolic Health Conference.
Usharani Pingali, MD, from the department of clinical pharmacology and therapeutics at Nizam’s Institute of Medical Sciences in Hyderabad, India, and colleagues analyzed 152 patients with diabetes (82 men) and 148 controls matched for age and sex (77 men) to determine endothelial dysfunction by endothelial-dependent vascular response to salbumatol and measuring the reflection index.
Reflection index was measured by photoplethysmography, a noninvasive method to determine digital pulse volume by measuring the transmission of infrared light through the pulp of the index finger.
“Early signs of diabetic vasculopathy include impaired endothelial function and increased arterial stiffness, which are independent predictors of CV events,” Pingali and colleagues wrote. “Testing [endothelial dysfunction] noninvasively using digital pulse photoplethysmography helps in evaluation of patients with CV risk.”
The primary outcome was change in reflection index after inhalation of salbutamol 400 µg. The researchers defined endothelial dysfunction as change in reflection index of less than 6%.
In controls, reflection index was 64.9% before salbutamol inhalation and 50.7% after (mean change, –14.2%), but in patients with diabetes it was 60.6% before salbutamol inhalation and 58.2% after (mean change, –2.4%), according to the researchers.
“The results of the present study highlight the importance of the reflection index in identifying vascular damage in subjects with diabetes mellitus who have high cardiovascular risk,” Pingali and colleagues wrote. “The change in reflection index was found to be a good, sensitive, simple and reliable method for assessing subjects with increased CV risk and also serves as a noninvasive independent predictor of cardiovascular morbidity. [Much evidence suggests] that endothelial dysfunction is the main etiological factor for micro- and macrovascular complications in [diabetes].”
The poster won an award for best poster at the meeting. – by Erik Swain
Reference:
Pingali U, et al. Poster 001. Presented at: Cardiometabolic Health Conference; Oct. 4-7, 2017; Boston.
Disclosure: Cardiology Today was unable to obtain relevant financial disclosures.