Diabetes mellitus 2 (DM2) is the seventh cause of death worldwide. One of the reasons is late diagnosis of vascular damage. Pulse wave velocity (PWV) has become an independent marker of arterial stiffness and cardiovascular risk. Moreover, the previous studies have shown the importance of beat-to-beat PWV measurement due to its variability among the heart cycle. However, variability of PWV (PWVv) of the whole body hasn't been examined yet. We have studied a group of DM II and heathy volunteers, to investigate the beat-to-beat mean PWV (PWVm) and PWVv in the different body positions. PWV of left lower and upper extremities were measured in DM2 (7 m/8 f, age 68+/-10 years, BP 158/90+/-19/9 mm Hg) and healthy controls (5 m/6 f, age 23+/-2 years, BP 117/76+/-9/5 mm Hg). Volunteers were lying in the resting position and of head-up-tilt in 45° (HUT) for 6 min. PWVv was evaluated as a mean power spectrum in the frequency bands LF and HF (0.04-0.15 Hz, 0.15-0.5 Hz). Resting PWVm of upper extremity was higher in DM2. HUT increased lower extremity PWVm only in DM2. Extremities PWVm ratio was significantly lower in DM2 during HUT compared to controls. LF and HF PWVv had the same response to HUT. Resting PWVv was higher in DM2. Lower extremity PWVv increased during HUT in both groups. PWVm and PWVv in DM2 differed between extremities and were significantly influenced by postural changes due to hydrostatic pressure. Increased resting PWVm and PWVv in DM2 is a marker of increased arterial stiffness.

Department of Physiology Faculty of Medicine Masaryk University Brno Czech Republic

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BODE AS, LEERMAKERS J, KROON JW, BRANDS P, PLANKEN RN, TORDOIR JHM. Determination of brachial artery stiffness prior to vascular access creation: reproducibility of pulse wave velocity assessment. Nephrol Dial Transplant. 2012;27:2370–2376. doi: 10.1093/ndt/gfr687. PubMed DOI

BOUTOUYRIE P, LACOLLEY P, GIRERD X, BECK L, SAFAR M, LAURENT S. Sympathetic activation decreases medium-sized arterial compliance in humans. Am J Physiol Heart Circ Physiol. 1994;267:H1368–H1376. doi: 10.1152/ajpheart.1994.267.4.H1368. PubMed DOI

BOUTOUYRIE P, TROPEANO AI, ASMAR R, GAUTIER I, BENETOS A, LACOLLEY P, LAURENT S. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension. 2002;39:10–15. doi: 10.1161/hy0102.099031. PubMed DOI

BROTHERS RM, WINGO JE, HUBING KA, Del COSO J, CRANDALL CG. Effect of whole body heat stress on peripheral vasoconstriction during leg dependency. J Appl Physiol. 2009;107:1704–1709. doi: 10.1152/japplphysiol.00711.2009. PubMed DOI PMC

CASALI KR, SCHAAN BD, MONTANO N, MASSIERER D, NETO FMF, TELÓ GH, LEDUR PS, REINHEIMER M, SBRUZZI G, GUS M. Correlation between very short and short-term blood pressure variability in diabetic-hypertensive and healthy subjects. Arq Bras Cardiol. 2018;110:157–165. doi: 10.5935/abc.20180020. PubMed DOI PMC

CHOREPSIMA S, ELEFTHERIADOU I, TENTOLOURIS A, MOYSSAKIS I, PROTOGEROU A, KOKKINOS A, SFIKAKIS PP, TENTOLOURIS N. Pulse wave velocity and cardiac autonomic function in type 2 diabetes mellitus. BMC Endocr Disord. 2017;17:27. doi: 10.1186/s12902-017-0178-2. PubMed DOI PMC

CRUICKSHANK K, RISTE L, ANDERSON SG, WRIGHT JS, DUNN G, GOSLING RG. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation. 2002;106:2085–2090. doi: 10.1161/01.CIR.0000033824.02722.F7. PubMed DOI

CYMBERKNOP LJ, GABALDÓN CASTILLO F, ARMENTANO RL. Beat to beat modulation of arterial pulse wave velocity induced by vascular smooth muscle tone. 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC); 2019; pp. 5030–5033. PubMed DOI

Del PASO GAR, GONZALEZ MI, HERNANDEZ JA. Comparison of baroreceptor cardiac reflex sensitivity estimates from inter-systolic and ECG R-R intervals. Psychophysiology. 2010;47:1102–1108. PubMed

GADDUM NR, SCHAEFFTER T, BÜHRER M, RUTTEN M, SMITH L, CHOWIENCZYK PJ, BEERBAUM PBJ. Beat-to-beat variation in pulse wave velocity during breathing maneuvers. Magn Reson Med. 2014;72:202–210. doi: 10.1002/mrm.24890. PubMed DOI

HAYANO J, BARROS AK, KAMIYA A, OHTE N, YASUMA F. Assessment of pulse rate variability by the method of pulse frequency demodulation. Biomed Eng Online. 2005;4:62. doi: 10.1186/1475-925X-4-62. PubMed DOI PMC

HONZIKOVA N, PENAZ J, FISER B. Spectral analysis of spontaneous fluctuations of some cardiovascular variables. Physiol Bohemoslov. 1975;24:441–442.

POLÓNIA J, BARBOSA L, SILVA JA, MALDONADO J. Different influences on central and peripheral pulse pressure, aortic wave reflections and pulse wave velocity of three different types of antihypertensive drugs. Rev Port Cardiol. 2003;22:1485–1492. PubMed

JOANNIDES R, RICHARD V, MOORE N, GODIN M, THUILLEZ C. Influence of sympathetic tone on mechanical properties of muscular arteries in humans. Am J Physiol Heart Circ Physiol. 1995;268:H794–H801. doi: 10.1152/ajpheart.1995.268.2.H794. PubMed DOI

JULIEN C. The enigma of Mayer waves: Facts and models. Cardiovasc Res. 2006;70:12–21. doi: 10.1016/j.cardiores.2005.11.008. PubMed DOI

KALLEM RR, MEYERS KEC, SAWINSKI DL, TOWNSEND RR. Variation and variability in carotid-femoral pulse wave velocity. Artery Res. 2013;7:230–233. doi: 10.1016/j.artres.2013.04.001. DOI

KIM EJ, PARK CG, PARK JS, SUH SY, CHOI CU, KIM JW, KIM SH, LIM HE, RHA SW, SEO HS, OH DJ. Relationship between blood pressure parameters and pulse wave velocity in normotensive and hypertensive subjects: invasive study. J Hum Hypertens. 2007;21:141–148. doi: 10.1038/sj.jhh.1002120. PubMed DOI

KINLAY S, CREAGER MA, FUKUMOTO M, HIKITA H, FANG JC, SELWYN AP, GANZ P. Endothelium-derived nitric oxide regulates arterial elasticity in human arteries in vivo. Hypertension. 2001;38:1049–1053. doi: 10.1161/hy1101.095329. PubMed DOI

LANGER P, JURAK P, VONDRA V, HALAMEK J, MESTANIK M, TONHAJZEROVA I, VISCOR I, SOUKUP L, MATEJKOVA M, ZAVODNA E, LEINVEBER P. Respiratory-induced hemodynamic changes measured by whole-body multichannel impedance plethysmography. Physiol Res. 2018;67:571–581. doi: 10.33549/physiolres.933778. PubMed DOI

LAURENT S, BOUTOUYRIE P, ASMAR R, GAUTIER I, LALOUX B, GUIZE L, DUCIMETIERE P, BENETOS A. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001;37:1236–1241. doi: 10.1161/01.HYP.37.5.1236. PubMed DOI

LEE SW, HAN SH, YOO TH, CHUNG W, PARK SK, CHAE DW, AHN C, OH K-H. Relationship between brachial-ankle and heart-femoral pulse wave velocities and the rapid decline of kidney function. Sci Rep. 2018;8:821. doi: 10.1038/s41598-018-19334-w. PubMed DOI PMC

MATEJKOVA M, VONDRA V, HALAMEK J, SOUKUP L, PLESINGER F, VISCOR I, JURAK P. Measurement of pulse wave velocity during Valsalva and Mueller maneuvers by whole body impedance monitor. Comp Cardiol. 2014;2014:1117–1120.

MATEJKOVA M, VONDRA V, SOUKUP L, PLESINGER F, VISCOR I, HALAMEK J, JURAK P. In: Murray A, editor. Changes of pulse wave velocity in the lower limbs in hypertensive patients; 2015 Computing in Cardiology Conference (CinC); New York: Institute of Electrical and Electronics Engineers; 2015. pp. 257–260. DOI

McENIERY CM, YASMIN HALL IR, QASEM A, WILKINSON IB, COCKCROFT JR, INVESTIGATORS ACCT. Normal vascular aging: Differential effects on wave reflection and aortic pulse wave velocity: The Anglo-Cardiff Collaborative Trial (ACCT) J Am Coll Cardiol. 2005;46:1753–1760. doi: 10.1016/j.jacc.2005.07.037. PubMed DOI

McENIERY CM, WALLACE S, MacKENZIE IS, McDONNELL B, YASMIN N, NEWBY DE, COCKCROFT JR, WILKINSON IB. Endothelial function is associated with pulse pressure, pulse wave velocity, and augmentation index in healthy humans. Hypertension. 2006;48:602–608. doi: 10.1161/01.HYP.0000239206.64270.5f. PubMed DOI

MEYER ML, TANAKA H, PALTA P, PATEL MD, CAMPLAIN R, COUPER D, CHENG S, AL QUNAIBET A, POON AK, HEISS G. Repeatability of central and peripheral pulse wave velocity measures: the atherosclerosis risk in communities (ARIC) study. Am J Hypertens. 2016;29:470–475. doi: 10.1093/ajh/hpv127. PubMed DOI PMC

MOUDR J, SVAČINOVÁ J, ZÁVODNÁ E, HONZÍKOVÁ N. The vibration plethysmographic method of arterial compliance analysis in dependence on transmural pressure. Physiol Res. 2014;63(Suppl 4):S489–S495. doi: 10.33549/physiolres.932929. PubMed DOI

MYERS CW, COHEN MA, ECKBERG DL, TAYLOR JA. A model for the genesis of arterial pressure Mayer waves from heart rate and sympathetic activity. Auton Neurosci Basic Clin. 2001;91:62–75. doi: 10.1016/S1566-0702(01)00289-2. PubMed DOI

NAMGOONG S, YANG J-P, HAN S-K, LEE Y-N, DHONG ES. Influence of peripheral neuropathy and microangiopathy on skin hydration in the feet of patients with diabetes mellitus. Wounds. 2019;31:173–178. PubMed

OBATA Y, MIZOGAMI M, SINGH S, NYHAN D, BERKOWITZ DE, STEPPAN J, BARODKA V. The effects of hemodynamic changes on pulse wave velocity in cardiothoracic surgical patients. BioMed Res Int. 2016;2016:e9640457. doi: 10.1155/2016/9640457. PubMed DOI PMC

PARATI G, SAUL JP, DIRIENZO M, MANCIA G. Spectral-analysis of blood-pressure and heart-rate-variability in evaluating cardiovascular regulation - a critical-appraisal. Hypertension. 1995;25:1276–1286. doi: 10.1161/01.HYP.25.6.1276. PubMed DOI

PLESINGER F, MATEJKOVA M, HALAMEK J, JURAK P, VISCOR I, VONDRA V. Influence of tilt load on pulse wave velocity in the lower limbs. 2014 8th Conference of the European Study Group on Cardiovascular Oscillations (ESGCO); Trento. 2014; pp. 77–78. DOI

RAJENDRA AU, PAUL JK, KANNATHAL N, LIM CM, SURI JS. Heart rate variability: a review. Med Biol Eng Comput. 2006;44:1031–1051. doi: 10.1007/s11517-006-0119-0. PubMed DOI

SCHÄFER A, VAGEDES J. How accurate is pulse rate variability as an estimate of heart rate variability? A review on studies comparing photoplethysmographic technology with an electrocardiogram. Int J Cardiol. 2013;166:15–29. doi: 10.1016/j.ijcard.2012.03.119. PubMed DOI

SOUKUP L, HRUSKOVA J, JURAK P, HALAMEK J, ZAVODNA E, VISCOR I, MATEJKOVA M, VONDRA V. Comparison of noninvasive pulse transit time determined from Doppler aortic flow and multichannel bioimpedance plethysmography. Med Biol Eng Comput. 2019;57:1151–1158. doi: 10.1007/s11517-018-01948-x. PubMed DOI

STRAIN WD, PALDÁNIUS PM. Diabetes, cardiovascular disease and the microcirculation. Cardiovasc Diabetol. 2018;17:57. doi: 10.1186/s12933-018-0703-2. PubMed DOI PMC

SVACINOVA J, JAVORKA M, NOVAKOVA Z, ZAVODNA E, CZIPPELOVA B, HONZIKOVA N. Development of causal interactions between systolic blood pressure and inter-beat intervals in adolescents. Physiol Res. 2015;64:821–829. doi: 10.33549/physiolres.933047. PubMed DOI

TRIPKOVIC L, HART KH, FROST GS, LODGE JK. Interindividual and intraindividual variation in pulse wave velocity measurements in a male population. Blood Press Monit. 2014;19:233–241. doi: 10.1097/MBP.0000000000000052. PubMed DOI

VERROTTI A, PREZIOSO G, SCATTONI R, CHIARELLI F. Autonomic neuropathy in diabetes mellitus. Front Endocrinol (Lausanne) 2014;5:205. doi: 10.3389/fendo.2014.00205. PubMed DOI PMC

VLACHOPOULOS C, AZNAOURIDIS K, STEFANADIS C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness. a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55:1318–1327. doi: 10.1016/j.jacc.2009.10.061. PubMed DOI

VONDRA V, JURAK P, VISCOR I, HALAMEK J, LEINVEBER P, MATEJKOVA M, SOUKUP L. A multichannel bioimpedance monitor for full-body blood flow monitoring. Biomed Tech (Berl) 2016;61:107–118. doi: 10.1515/bmt-2014-0108. PubMed DOI

WANG R, JIA W, MAO Z-H, SCLABASSI RJ, SUN M. Cuff-free blood pressure estimation using pulse transit time and heart rate. Int Conf Signal Process Proc. 2014;2014:115–118. doi: 10.1109/ICOSP.2014.7014980. PubMed DOI PMC

WANG S, RANDALL DC, KNAPP CF, PATWARDHAN AR, NELSON KR, KAROUNOS DG, EVANS JM. Blood pressure regulation in diabetic patients with and without peripheral neuropathy. Am J Physiol Regul Integr Comp Physiol. 2012;302:R541–R550. doi: 10.1152/ajpregu.00174.2011. PubMed DOI PMC

WELTMAN G, SULLIVAN G, BREDON D. The continuous measurement of arterial pulse wave velocity. Med Electron Biol Eng. 1964;2:145–154. doi: 10.1007/BF02484213. PubMed DOI

WEN W, LUO R, TANG X, TANG L, HUANG HX, WEN X, HU S, PENG B. Age-related progression of arterial stiffness and its elevated positive association with blood pressure in healthy people. Atherosclerosis. 2015;238:147–152. doi: 10.1016/j.atherosclerosis.2014.10.089. PubMed DOI

ZHANG M, BAI Y, YE P, LUO L, XIAO W, WU H, LIU D. Type 2 diabetes is associated with increased pulse wave velocity measured at different sites of the arterial system but not augmentation index in a Chinese population. Clin Cardiol. 2011;34:622–627. doi: 10.1002/clc.20956. PubMed DOI PMC

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