| Autor: |
Pop-Busui, Rodica, Kirkwood, Ian, Schmid, Helena, Marinescu, Victor, Schroeder, Justin, Larkin, Dennis, Yamada, Elina, Raffel, David M., Stevens, Martin J. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of the American College of Cardiology. (12):2368-2374 |
| ISSN: |
0735-1097 |
| DOI: |
10.1016/j.jacc.2004.09.033 |
| Popis: |
ObjectivesThis study was designed to explore the relationships of early diabetic microangiopathy to alterations of cardiac sympathetic tone and myocardial blood flow (MBF) regulation in subjects with stable type 1 diabetes.BackgroundIn diabetes, augmented cardiac sympathetic tone and abnormal MBF regulation may predispose to myocardial injury and enhanced cardiac risk.MethodsSubject groups comprised healthy controls (C) (n = 10), healthy diabetic subjects (DC) (n = 12), and diabetic subjects with very early diabetic microangiopathy (DMA+) (n = 16). [11C]meta-hydroxyephedrine ([11C]HED) and positron emission tomography (PET) were used to explore left ventricular (LV) sympathetic integrity and [13N]ammonia-PET to assess MBF regulation in response to cold pressor testing (CPT) and adenosine infusion.ResultsDeficits of LV [11C]HED retention were extensive and global in the DMA+ subjects (36 ± 31% vs. 1 ± 1% in DC subjects; p < 0.01) despite preserved autonomic reflex tests. On CPT, plasma norepinephrine excursions were two-fold greater than in C and DC subjects (p < 0.05), and basal LV blood flow decreased (−12%, p < 0.05) in DMA+ but not in C or DC subjects (+45% and +51%, respectively). On adenosine infusion, compared with C subjects, MBF reserve decreased by ∼45% (p < 0.05) in DMA+ subjects. Diastolic dysfunction was detected by two-dimensional echocardiography in 5 of 8 and 0 of 8 consecutively tested DMA+ and DC subjects, respectively.ConclusionsAugmented cardiac sympathetic tone and responsiveness and impaired myocardial perfusion may contribute to myocardial injury in diabetes. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
