Document Detail


Relationship between hyperglycemia and coronary vascular resistance in non-diabetic patients.
MedLine Citation:
PMID:  19147243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hyperglycemia upon hospital admission in patients with acute myocardial infarction is associated with the no-reflow phenomenon after successful reperfusion, and increased mortality. However, the mechanism underlying this phenomenon remains unclear. Therefore, the aim of this study was to characterize coronary hemodynamics in a homogenous group of non-diabetic patients without coronary artery disease.
METHODS AND RESULTS: A total of 104 consecutive non-diabetic patients (mean age, 62+/-14 years) without coronary artery disease underwent Doppler flow study of the left anterior descending coronary artery. Vascular reactivity was examined by intra-coronary administration of papaverine, acetylcholine (Ach), and nitroglycerin using a Doppler guidewire. Coronary vascular resistance (CVR) was calculated as the mean arterial pressure divided by coronary blood flow (CBF). Baseline CVR was shown as CVR at control and minimal CVR was shown as CVR with papaverine administration. Fasting plasma glucose (FPG) level had a significant, positive correlation with baseline CVR and minimal CVR (r=0.24, p<0.02 and r=0.21, p<0.05, respectively). Hemoglobin A1c (HbA1c) also had a significant, positive correlation with baseline CVR and minimal CVR (r=0.31, p<0.01 and r=0.32, p<0.01, respectively). The percent change in CBF induced by Ach was inversely correlated with HbA1c but not with FPG (r=0.22, p<0.05 and r=0.06, p=0.57, respectively). By contrast, neither FPG nor HbA1c had significant correlation with coronary flow reserve to papaverine.
CONCLUSION: These data demonstrate that elevated glucose levels are associated with increases in baseline and minimal coronary vascular resistance. These changes may contribute to unfavorable coronary hemodynamics in non-diabetic patients without coronary heart disease.
Authors:
Hitoshi Ichiki; Shuichi Hamasaki; Mitsuhiro Nakasaki; Sanemasa Ishida; Akiko Yoshikawa; Tetsuro Kataoka; Masakazu Ogawa; Keishi Saihara; Hideki Okui; Koji Orihara; Takuro Shinsato; Naoya Oketani; Takahiro Shirasawa; Yuichi Ninomiya; So Kuwahata; Shoji Fujita; Takuro Takumi; Yasuhisa Iriki; Satoshi Yoshino; Takehiko Matsushita; Chuwa Tei
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-01-15
Journal Detail:
Title:  International journal of cardiology     Volume:  141     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  44-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008. Published by Elsevier Ireland Ltd.
Affiliation:
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Coronary Artery Disease / complications*,  physiopathology*,  radiography
Coronary Circulation / physiology
Coronary Vessels / physiology*
Diabetes Mellitus / physiopathology,  radiography
Female
Humans
Hyperglycemia / complications*,  physiopathology*,  radiography
Male
Middle Aged
Vascular Resistance* / physiology
Young Adult

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