OBJECTIVES: We sought to determine the differences in coronary microvascular function between patients with type 1 (insulin-deficient) and type 2 (insulin-resistant) diabetes mellitus (DM). BACKGROUND: Coronary vascular function is impaired in patients with DM. However, it is unclear whether the type and/or severity of this vascular dysfunction are similar in patients with type 1 and type 2 DM. METHODS: We studied 35 young subjects with DM (18 with type 1 and 17 with type 2), who were free of overt cardiovascular complications, and 11 age-matched healthy controls. Positron emission tomography imaging was used to measure myocardial blood flow (MBF) at rest, during adenosine-induced hyperemia (reflecting primarily endothelium-independent vasodilation), and in response to cold pressor test (CPT) (reflecting primarily endothelium-dependent vasodilation). RESULTS: The two groups of diabetics were similar with respect to age and glycemic control. The duration of diabetes was longer and high-density lipoprotein cholesterol levels were higher in type 1 than in type 2 diabetics. Basal MBF was similar in the three groups studied. The increase (from baseline) in MBF with adenosine was similar in the subjects with type 1 (161 +/- 18%) and type 2 (185 +/- 19%) DM, but lower than in the controls (351 +/- 43%) (p < 0.001 for the comparison with both groups of diabetics). Similarly, the increase in MBF during the CPT was comparable in the subjects with type 1 (23 +/- 4%) and type 2 (19 +/- 3%) DM, but lower compared with the controls (66 +/- 12%) (p < 0.0001 for the comparison with both groups of diabetics). These differences persisted after adjusting for the duration of diabetes, insulin treatment, metabolic abnormalities, and autonomic neuropathy. CONCLUSIONS: These results demonstrate markedly reduced and similar endothelium-dependent and -independent coronary vasodilator function in subjects with both type 1 and type 2 DM. These results suggest a key role of chronic hyperglycemia in the pathogenesis of vascular dysfunction in diabetes.
OBJECTIVES: We sought to determine the differences in coronary microvascular function between patients with type 1 (insulin-deficient) and type 2 (insulin-resistant) diabetes mellitus (DM). BACKGROUND: Coronary vascular function is impaired in patients with DM. However, it is unclear whether the type and/or severity of this vascular dysfunction are similar in patients with type 1 and type 2 DM. METHODS: We studied 35 young subjects with DM (18 with type 1 and 17 with type 2), who were free of overt cardiovascular complications, and 11 age-matched healthy controls. Positron emission tomography imaging was used to measure myocardial blood flow (MBF) at rest, during adenosine-induced hyperemia (reflecting primarily endothelium-independent vasodilation), and in response to cold pressor test (CPT) (reflecting primarily endothelium-dependent vasodilation). RESULTS: The two groups of diabetics were similar with respect to age and glycemic control. The duration of diabetes was longer and high-density lipoprotein cholesterol levels were higher in type 1 than in type 2 diabetics. Basal MBF was similar in the three groups studied. The increase (from baseline) in MBF with adenosine was similar in the subjects with type 1 (161 +/- 18%) and type 2 (185 +/- 19%) DM, but lower than in the controls (351 +/- 43%) (p < 0.001 for the comparison with both groups of diabetics). Similarly, the increase in MBF during the CPT was comparable in the subjects with type 1 (23 +/- 4%) and type 2 (19 +/- 3%) DM, but lower compared with the controls (66 +/- 12%) (p < 0.0001 for the comparison with both groups of diabetics). These differences persisted after adjusting for the duration of diabetes, insulin treatment, metabolic abnormalities, and autonomic neuropathy. CONCLUSIONS: These results demonstrate markedly reduced and similar endothelium-dependent and -independent coronary vasodilator function in subjects with both type 1 and type 2 DM. These results suggest a key role of chronic hyperglycemia in the pathogenesis of vascular dysfunction in diabetes.
Authors: Jonathan Rubin; Kunihiro Matsushita; Christie M Ballantyne; Ron Hoogeveen; Josef Coresh; Elizabeth Selvin Journal: J Am Coll Cardiol Date: 2012-01-31 Impact factor: 24.094
Authors: Erick Alexanderson; Patricio Cruz; Angélica Vargas; Aloha Meave; Alejandro Ricalde; Jose A Talayero; José Luis Romero-Ibarra; Tovë M Goldson; Olga L Vera-Lastra; Gabriela Medina; Luis Jara; Mary-Carmen Amigo Journal: J Nucl Cardiol Date: 2007-07-02 Impact factor: 5.952
Authors: Thomas H Schindler; Xiao-Li Zhang; Gabriella Vincenti; Leila Mhiri; René Lerch; Heinrich R Schelbert Journal: J Nucl Cardiol Date: 2007-07 Impact factor: 5.952