Effects of type 2 diabetes mellitus on coronary microvascular function and myocardial perfusion in patients without obstructive coronary artery disease
Purpose We assessed the impact of type 2 diabetes, in the presence of other major cardiovascular risk factors, on coronary microvascular function and myocardial perfusion in patients without obstructive coronary artery disease (CAD). Methods In this prospective study, 23 patients with type 2 diabetes and 26 nondiabetic patients matched for age, sex and other cardiovascular risk factors underwent a cold pressure test (CPT) and dipyridamole transthoracic echocardiography to determine their coronary flow (CF) ratio. Within 2 weeks, all diabetic patients also underwent dipyridamole-rest myocardial perfusion single-photon emission (MPS) CT. None of the patients with or without diabetes had significant CAD on invasive coronary angiography. Results The CPT-CF ratio was significantly lower in diabetic patients than in nondiabetic patients (1.46 ± 0.26 vs. 1.71 ± 0.32, p = 0.006) and was correlated significantly with fasting glycaemia (r = −0.35, p = 0.01), but not with glycated haemoglobin. The dipyridamole-CF ratio was also lower in diabetic patients than in nondiabetic patients (2.38 ± 0.74 vs. 2.75 ± 0.49, p = 0.04). On MPS imaging, 5 diabetic patients (22%) had stress-induced ischaemia and the remaining 18 (78%) had normal myocardial perfusion. The dipyridamole-CF ratio was not different in patients with and without reversible defects (2.3 ± 1.1 vs. 2.4 ± 0.6, p = 0.97). Conclusion Coronary microvascular function is impaired in type 2 diabetic patients without significant CAD, compared to nondiabetic patients with similar other cardiovascular risk factors. In the majority of diabetic patients, microvascular dysfunction is associated with normal myocardial perfusion..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2012 |
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| Erschienen: |
2012 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
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| Enthalten in: |
European journal of nuclear medicine & molecular imaging - 39(2012), 7 vom: 12. Apr., Seite 1199-1206 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Marciano, Caterina [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Microvascular dysfunction |
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| Anmerkungen: |
© Springer-Verlag 2012 |
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| doi: |
10.1007/s00259-012-2117-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2041154500 |
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| 520 | |a Purpose We assessed the impact of type 2 diabetes, in the presence of other major cardiovascular risk factors, on coronary microvascular function and myocardial perfusion in patients without obstructive coronary artery disease (CAD). Methods In this prospective study, 23 patients with type 2 diabetes and 26 nondiabetic patients matched for age, sex and other cardiovascular risk factors underwent a cold pressure test (CPT) and dipyridamole transthoracic echocardiography to determine their coronary flow (CF) ratio. Within 2 weeks, all diabetic patients also underwent dipyridamole-rest myocardial perfusion single-photon emission (MPS) CT. None of the patients with or without diabetes had significant CAD on invasive coronary angiography. Results The CPT-CF ratio was significantly lower in diabetic patients than in nondiabetic patients (1.46 ± 0.26 vs. 1.71 ± 0.32, p = 0.006) and was correlated significantly with fasting glycaemia (r = −0.35, p = 0.01), but not with glycated haemoglobin. The dipyridamole-CF ratio was also lower in diabetic patients than in nondiabetic patients (2.38 ± 0.74 vs. 2.75 ± 0.49, p = 0.04). On MPS imaging, 5 diabetic patients (22%) had stress-induced ischaemia and the remaining 18 (78%) had normal myocardial perfusion. The dipyridamole-CF ratio was not different in patients with and without reversible defects (2.3 ± 1.1 vs. 2.4 ± 0.6, p = 0.97). Conclusion Coronary microvascular function is impaired in type 2 diabetic patients without significant CAD, compared to nondiabetic patients with similar other cardiovascular risk factors. In the majority of diabetic patients, microvascular dysfunction is associated with normal myocardial perfusion. | ||
| 650 | 4 | |a Type 2 diabetes mellitus | |
| 650 | 4 | |a Microvascular dysfunction | |
| 650 | 4 | |a Myocardial perfusion imaging | |
| 700 | 1 | |a Galderisi, Maurizio |4 aut | |
| 700 | 1 | |a Gargiulo, Paola |4 aut | |
| 700 | 1 | |a Acampa, Wanda |4 aut | |
| 700 | 1 | |a D’Amore, Carmen |4 aut | |
| 700 | 1 | |a Esposito, Roberta |4 aut | |
| 700 | 1 | |a Capasso, Enza |4 aut | |
| 700 | 1 | |a Savarese, Gianluigi |4 aut | |
| 700 | 1 | |a Casaretti, Laura |4 aut | |
| 700 | 1 | |a Iudice, Francesco Lo |4 aut | |
| 700 | 1 | |a Esposito, Giovanni |4 aut | |
| 700 | 1 | |a Rengo, Giuseppe |4 aut | |
| 700 | 1 | |a Leosco, Dario |4 aut | |
| 700 | 1 | |a Cuocolo, Alberto |4 aut | |
| 700 | 1 | |a Perrone-Filardi, Pasquale |4 aut | |
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