Correlation between Diastolic Function and Endothelial Function in Patients with Type 2 Diabetes and Hypertension

Ricardo Bedirian1, *, Mario Fritsch Neves1, Wille Oigman1, Ronaldo Altenburg Odebrecht Curi Gismondi1, Cesar Romaro Pozzobon1, Marcia Cristina Boaventura Ladeira1, Marcia Bueno Castier2
1 Department of Clinical Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
2 Department of Medical Specialties, State University of Rio de Janeiro, Rio de Janeiro, Brazil

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© Bedirian et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Clinical Medicine, State University of Rio de Janeiro, Boulevard 28 de Setembro 77/329, 20551-030 Rio de Janeiro, RJ, Brazil; Tel: +55 212 868 8484; E-mail:



Endothelial dysfunction may be involved in the pathophysiology of cardiac abnormalities in patients with diabetes mellitus (DM). A correlation between endothelial dysfunction and diastolic dysfunction in patients with type 1 DM has been demonstrated, but this relationship has not been well investigated in type 2 DM.


Compare groups of patients with type 2 DM and hypertension with and without diastolic dysfunction using endothelial function indexes, and to assess whether correlations exist between the diastolic function and the endothelial function indexes.


This was a cross-sectional study of 34 men and women with type 2 DM and hypertension who were aged between 40 and 70 years and were categorized based on assessments of their Doppler echocardiographic parameters as having normal (14 patients) and abnormal (20 patients) diastolic function. Flow-mediated dilatation (FMD) assessments of the brachial artery evaluated the patients’ endothelial function.


The mean maximum FMD was 7.15 ± 2.80% for the patients with diastolic dysfunction and it was 11.85 ± 4.77% for the patients with normal diastolic function (p = 0.004). Correlations existed between the maximum FMD and the E/e' ratio (p = 0.040, r = -0.354) and the early wave velocity (e') at the lateral mitral annulus (p = 0.002, r = 0.509).


The endothelial function assessed by FMD was worse in hypertensive diabetic patients with diastolic dysfunction. There were correlations between the diastolic function indexes and the endothelial function indexes in our sample.

Keywords: Arterial intima, Diabetes mellitus, Diastole, Doppler echocardiography, Doppler ultrasonography, Endothelium, Hypertension, Left ventricle.