Title of article :
Retinopathy Identifies Marked Restriction of Coronary Flow Reserve in Patients With Diabetes Mellitus
Author/Authors :
Takashi Akasak MD، نويسنده , , Kiyoshi Yoshid MD FACC، نويسنده , , Takeshi Hozumi MD، نويسنده , , Tsutomu Takagi MD، نويسنده , , Shuichiro Kaji MD، نويسنده , , Takahiro Kawamoto MD، نويسنده , , Shigefumi Moriok MD، نويسنده , , Junichi Yoshikaw MD FACC، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 1997
Pages :
7
From page :
935
To page :
941
Abstract :
Objectives. This study sought to assess the differences in coronary flow reserve in patients with and without diabetic retinopathy. Background. Microvascular abnormalities throughout the body and impairment of coronary flow reserve have been described in patients with diabetes mellitus. However, the relation between diabetic retinopathy and coronary microvascular disease has not been investigated. Methods. The study included 29 patients with diabetes mellitus (18 with and 11 without diabetic retinopathy) and 15 control patients with chest pain and normal coronary arteries. Diabetic retinopathy was nonproliferative in all 18 patients with this disorder (8 had background, 10 preproliferative retinopathy). Five minutes after injection of 3 mg of isosorbide dinitrate, phasic flow velocities were recorded in the proximal segment of the angiographically normal left anterior descending coronary artery at rest and during hyperemi (0.14 mg/kg body weight per min of adenosine infused intravenously) using 0.014-in. 15-MHz Doppler guide wire. Coronary blood flow was calculated, and coronary flow reserve was obtained from the hyperemic/baseline flow ratio. Results. Coronary blood flow was significantly lower during hyperemi ([mean ± SD] 107 ± 23 and 116 ± 18 vs. 136 ± 17 ml/min, respectively) and higher at baseline (58 ± 16 and 45 ± 12 vs. 37 ± 10 ml/min, respectively) in diabetic patients with and without retinopathy than in control subjects (p < 0.05 for both diabetic groups). As result, coronary flow reserve in both groups of diabetic patients was significantly lower than in control patients (1.9 ± 0.4 and 2.8 ± 0.3 vs. 3.3 ± 0.4, respectively, p < 0.01 for both diabetic groups), and its reduction was greater in patients with than without retinopathy (p < 0.01). Furthermore, in patients with diabetic retinopathy, maximal hyperemic coronary flow (102 ± 11 vs. 114 ± 16 ml/min, p < 0.05) and flow reserve (1.6 ± 0.2 vs. 2.3 ± 0.2, p < 0.01) were significantly lower in those with preproliferative than background retinopathy. Conclusions. Coronary flow reserve is significantly restricted in patients with diabetes mellitus, and its reduction is more marked in those with diabetic retinopathy, especially in advanced retinopathy. Thus, diabetic retinopathy should identify marked restriction of coronary flow reserve in patients with diabetes mellitus.
Keywords :
ANOVA , Analysis of variance , ECG , Electrocardiogram , electrocardiographic
Journal title :
JACC (Journal of the American College of Cardiology)
Serial Year :
1997
Journal title :
JACC (Journal of the American College of Cardiology)
Record number :
480184
Link To Document :
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