Περίληψη:
Evaluation of coronary microvascular function can be obtained through
coronary flow reserve measurements. The aim of this study was to
evaluate the coronary microvascular function by using
transesophageal-Doppler echocardiographic assessment of coronary flow
reserve. The study included 32 normotensive patients with type II
diabetes mellitus (group A) of short duration (6.1+/-3.8 years) aged
55.4+/-9.4 years and 14 healthy volunteers matched for age, gender and
BMI (group B). No patients had clinical evidence of coronary artery
disease and all of them produced a negative recent stress ECG test.
Excluded from the study were patients with anemia, left ventricular
hypertrophy, arrhythmia, congenital, or acquired structural heart
disease. All subjects underwent transesophageal-Doppler
echocardiography. Satisfactory coronary blood flow velocity recordings
could be obtained from the initial segment of the left anterior
descending coronary artery in healthy volunteers and in 27 patients at
baseline and 2 min after dipyridamole infusion (0.56 mg/kg, for 4 min).
In the remaining 5 patients no satisfactory recordings were available.
The indexes of coronary flow reserve, i.e. the ratios of dipyridamole
over basal maximum and mean diastolic velocities were calculated.
Dipyridamole/rest maximal coronary reserve (Table 3) was 1.946+/-0.743,
while this ratio for the mean diastolic velocity was 1.969+/-0.805 in
group A. The respective values for group B, were 2.811+/-0.345 (P=0.000
vs. group A) and 2.914+/-0.303 (P=0.000 vs. group A). Thus, the increase
in coronary flow reserve although present in both groups, it was more
impressive in the normal group. Multiple regression logistic analysis
of: age, sex, smoking, glucosylated hemoglobin, duration of diabetes and
type of therapy, did not show any correlation of these parameters with
the above ratios. This study shows that coronary flow reserve, as
measured with transesophageal echocardiography-Doppler, is severely
impaired in normotensive patients with type II diabetes, with relatively
short duration of the disease. (C) 1997 Elsevier Science Ireland Ltd.
Συγγραφείς:
Kranidis, A
Zamanis, N
Mitrakou, A
Patsilinakos, S and
Bouki, T
Tountas, N
Anthopoulos, P
Raptis, S and
Anthopoulos, L
