| Structural alterations of the coronary arterial wall are associated with myocardial flow heterogeneity in type 2 diabetes mellitus. | |
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MedLine Citation:
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PMID: 18704406 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To determine the relationship between carotid intima-media thickness (IMT), coronary artery calcification (CAC), and myocardial blood flow (MBF) at rest and during vasomotor stress in type 2 diabetes mellitus (DM). METHODS: In 68 individuals, carotid IMT was measured using high-resolution vascular ultrasound, while the presence of CAC was determined with electron beam tomography (EBT). Global and regional MBF was determined in milliliters per gram per minute with (13)N-ammonia and positron emission tomography (PET) at rest, during cold pressor testing (CPT), and during adenosine (ADO) stimulation. RESULTS: There was neither a relationship between carotid IMT and CAC (r = 0.10, p = 0.32) nor between carotid IMT and coronary circulatory function in response to CPT and during ADO (r = -0.18, p = 0.25 and r = 0.10, p = 0.54, respectively). In 33 individuals, EBT detected CAC with a mean Agatston-derived calcium score of 44 +/- 18. There was a significant difference in regional MBFs between territories with and without CAC at rest and during ADO-stimulated hyperemia (0.69 +/- 0.24 vs. 0.74 +/- 0.23 and 1.82 +/- 0.50 vs. 1.95 +/- 0.51 ml/g/min; p < or = 0.05, respectively) and also during CPT in DM but less pronounced (0.81 +/- 0.24 vs. 0.83 +/- 0.23 ml/g/min; p = ns). The increase in CAC was paralleled with a progressive regional decrease in resting as well as in CPT- and ADO-related MBFs (r = -0.36, p < or = 0.014; r = -0.46, p < or = 0.007; and r = -0.33, p < or = 0.041, respectively). CONCLUSIONS: The absence of any correlation between carotid IMT and coronary circulatory function in type 2 DM suggests different features and stages of early atherosclerosis in the peripheral and coronary circulation. PET-measured MBF heterogeneity at rest and during vasomotor stress may reflect downstream fluid dynamic effects of coronary artery disease (CAD)-related early structural alterations of the arterial wall. |
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Authors:
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Thomas H Schindler; Alvaro D Facta; John O Prior; Jerson Cadenas; Xiao-Li Zhang; Yanjie Li; James Sayre; Jonathan Goldin; Heinrich R Schelbert |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2008-08-15 |
Journal Detail:
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Title: European journal of nuclear medicine and molecular imaging Volume: 36 ISSN: 1619-7089 ISO Abbreviation: Eur. J. Nucl. Med. Mol. Imaging Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-01-27 Completed Date: 2009-03-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140988 Medline TA: Eur J Nucl Med Mol Imaging Country: Germany |
Other Details:
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Languages: eng Pagination: 219-29 Citation Subset: IM |
Affiliation:
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Department of Molecular and Medical Pharmacology, Radiological Science, David Geffen School of Medicine, University of California at Los Angeles, 10833 Le Conte Avenue, 23-120 CHS, P.O. Box 173517, Los Angeles, CA 90095-1735, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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pharmacology Adult Calcinosis Carotid Arteries / pathology, physiopathology Cold Temperature Coronary Circulation* Coronary Vessels / metabolism, pathology*, physiopathology* Diabetes Mellitus, Type 2 / physiopathology*, radionuclide imaging Female Humans Male Middle Aged Positron-Emission Tomography Rest Sympathetic Nervous System / drug effects Vasodilation / drug effects |
| Grant Support | |
ID/Acronym/Agency:
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HL 33177/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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