Document Detail

Impairment of coronary vascular reserve and ACh-induced coronary vasodilation in diabetic patients with angiographically normal coronary arteries and normal left ventricular systolic function.
MedLine Citation:
PMID:  8513969     Owner:  NLM     Status:  MEDLINE    
Evidence is increasing for small-vessel disease and disturbance of endothelium-dependent vasodilation in diabetic patients. The aim of this study was to compare coronary circulation in 11 diabetic patients (6 type I and 5 type II) and 7 control subjects. All patients had normal left ventricular systolic function and angiographically normal coronary arteries. To evaluate the maximal area of coronary microcirculation, coronary vascular reserve was determined by intracoronary Doppler and a maximally vasodilating dose of intracoronary papaverine (peak-to-resting coronary flow velocity ratio). To assess coronary endothelial function responses to stepwise intracoronary infusion of acetylcholine (10(-8) to 10(-5) M coronary estimated concentrations) were analyzed on four different segments in each patient by quantitative angiography. Peak-to-resting coronary flow velocity ratio was lower in diabetic patients than in control subjects (3.9 +/- 0.9 and 5.0 +/- 0.7, respectively, P < 0.02). Acetylcholine did not produce any diameter change at 10(-8) and 10(-7) M, but a progressive diameter reduction was observed at 10(-6) and 10(-5) M (-8.0 +/- 15.2%, P < 0.02 and -24.0 +/- 13.6%, P < 0.001, respectively). In control subjects, a progressive diameter dilation was produced from 10(-8) to 10(-6) M acetylcholine (5.1 +/- 3.4, 12.1 +/- 7.0, and 16.4 +/- 7.3%, respectively, all P < 0.001), and a moderate reduction was observed at 10(-5) M (-4.9 +/- 7.5%, P < 0.02). In the two groups, all segments dilated similarly after intracoronary isosorbide dinitrate.(ABSTRACT TRUNCATED AT 250 WORDS)
A Nitenberg; P Valensi; R Sachs; M Dali; E Aptecar; J R Attali
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes     Volume:  42     ISSN:  0012-1797     ISO Abbreviation:  Diabetes     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-07-19     Completed Date:  1993-07-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372763     Medline TA:  Diabetes     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1017-25     Citation Subset:  AIM; IM    
Department of Cardiac Investigation, CHU Xavier-Bichat, Paris, France.
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MeSH Terms
Acetylcholine / pharmacology*
Analysis of Variance
Blood Flow Velocity / drug effects
Blood Pressure / drug effects
Coronary Angiography
Coronary Circulation* / drug effects
Coronary Vessels / drug effects*,  physiology,  physiopathology
Diabetes Mellitus / blood,  physiopathology*
Diabetes Mellitus, Type 1 / physiopathology
Diabetes Mellitus, Type 2 / physiopathology
Diabetic Angiopathies / blood,  physiopathology*
Dose-Response Relationship, Drug
Heart Rate / drug effects
Middle Aged
Muscle, Smooth, Vascular / drug effects,  physiology,  physiopathology
Reference Values
Vascular Resistance / drug effects
Vasodilation / drug effects*
Ventricular Function, Left*
Reg. No./Substance:

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