Global myocardial perfusion and diastolic function are impaired to a similar extent in patients with type 2 diabetes mellitus and in patients with coronary artery disease—evaluation by contrast echocardiography and pulsed tissue Doppler
| Autor: | A. Hansen, T. Siegmund, H. von Bibra, Petra-Maria Schumm-Draeger, V. Dounis, J. Jensen |
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| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism Diastole Blood Pressure Coronary Disease Type 2 diabetes Coronary artery disease Heart Rate Reference Values Coronary Circulation Internal medicine Diabetes mellitus Internal Medicine Humans Medicine Ejection fraction business.industry Heart Ultrasonography Doppler Blood flow Middle Aged medicine.disease Pulse pressure Diabetes Mellitus Type 2 Echocardiography Cardiology business Perfusion Diabetic Angiopathies |
| Zdroj: | Diabetologia. 49:2729-2740 |
| ISSN: | 1432-0428 0012-186X |
| DOI: | 10.1007/s00125-006-0398-x |
| Popis: | Using modern echocardiography, we quantified the extent of global myocardial function and perfusion abnormalities in patients with type 2 diabetes and compared this with the hypothetically similar extent of impairments in patients with coronary artery disease (CAD). This case–control study (66 patients) compared four age-matched groups: control, type 2 diabetic, CAD, and diabetic subjects with CAD (DCAD) and left ventricular ejection fraction >50%. CAD patients had 1–2 vessel disease. Diastolic and systolic myocardial velocities were assessed with pulsed tissue Doppler. Global myocardial perfusion was assessed with contrast echocardiography as indices of capillary blood volume and myocardial blood flow at maximal vasodilatation. In CAD and DCAD patients, functional and perfusion parameters were additionally assessed in the territory with a normal coronary angiogram reading, providing a model for comparison with the global data from control and diabetic patients. Comparing diabetic with control subjects, myocardial velocity at early diastole was impaired (8.8±1.8 vs 10.1±1.7 cm/s; p=0.02) and correlated inversely with age, HbA1c and pulse pressure (R 2=0.761). Capillary blood volume (16.6±5.0 vs 24.4±4.9%) and blood flow (56±35 vs 114±40) were decreased (p=0.001). In CAD patients, myocardial velocity at early diastole was similarly decreased (p=0.02). CAD and DCAD patients were receiving more cardiovascular preventive therapy for the same extent of impaired global perfusion as in the less extensively treated diabetes group without CAD (p |
| Databáze: | OpenAIRE |
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