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- Title
Relationships between Endothelial Dysfunction and Coronary Artery Stenoses in Asymptomatic Type 2 Diabetic Patients.
- Authors
Cosson, Emmanuel; Nguyen, Minh Tuan; Pham, Isabelle; Chanu, Bernard; Nitenberg, Alain; Valensi, Paul
- Abstract
Silent myocardial ischemia (SMI) when associated with artery stenosis or endothelial dysfunction is predictive of cardiovascular events in type 2 diabetic patients. The aims of the present study were to examine the relationships between peripheral and coronary endothelial functions (PEF and CEF), left ventricular function and the presence of significant coronary artery stenoses in asymptomatic type 2 diabetic patients. Fifty asymptomatic type 2 diabetic patients (36 men; aged 61±7 years, mean duration of diabetes 14±8 years) with a normal resting ECG were included. They were tested for SMI defined as an abnormal ergometric stress test, dipyridamole myocardial scintigraphy or dobutamine stress echocardiography. A coronarography was performed in patients with SMI. PEF was assessed by post-occlusive hyperemia of the brachial artery (n=50) and CEF by coronary trans-thoracic Doppler during a cold pressor test (CPT) (n=25). Patients were classified in 3 groups: group 1: no SMI (n=26); group 2: SMI, no significant coronary artery stenosis (n=17) and group 3: SMI and significant coronary artery stenoses (n=6). Although hyperemia induced a similar increase in mean blood flow velocity in the 3 groups, the variations in brachial artery diameter (diameter at one min./basal diameter) were different between group 3 (0.96±.05) and group 1 (1.01±.04, p<0.01), and group 2 (1.01±.04, p<0.01). There was a correlation between the changes in brachial artery diameter and the left ventricle relaxation index E/A (r=0.32; p<0.05), but not with the left ventricular mass which was similar in the 3 groups of patients. CPT induced a similar increase in mean coronary blood flow velocity and velocity time integral in the 3 groups of patients. No correlation was found between CEF and PEF in the 3 groups of patients taken together. To conclude, peripheral endothelial function is altered in asymptomatic type 2 diabetic patients with significant coronary artery stenosis and is associated with an altered left ventricle relaxation.
- Subjects
CAROTID artery stenosis; VASCULAR endothelium; STENOSIS; PEOPLE with diabetes; TYPE 2 diabetes; LEFT heart ventricle
- Publication
Diabetes, 2007, Vol 56, pA587
- ISSN
0012-1797
- Publication type
Article