Improvement in coronary vascular dysfunction produced with euglycaemic control in patients with type 2 diabetes
Details
Serval ID
serval:BIB_EABE5859AF19
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Improvement in coronary vascular dysfunction produced with euglycaemic control in patients with type 2 diabetes
Journal
Heart
ISSN
1468-201X
Publication state
Published
Issued date
03/2007
Peer-reviewed
Oui
Volume
93
Number
3
Pages
345-9
Notes
Journal Article
Research Support, N.I.H., Extramural --- Old month value: Mar
Research Support, N.I.H., Extramural --- Old month value: Mar
Abstract
OBJECTIVE: To determine the effect of plasma glucose lowering on coronary circulatory function in type 2 diabetes mellitus. METHODS: Twenty patients with type 2 diabetes and 18 weight-matched controls were studied. At baseline, myocardial blood flow (MBF) was measured with [(13)N]ammonia and positron emission tomography at rest, during cold pressor testing (CPT), and during adenosine hyperaemia. In diabetic patients, MBF and blood chemistry were analysed again after 3 months of glucose-lowering treatment with glyburide and metformin. RESULTS: Although hyperaemic MBF did not differ significantly between the patients and controls (1.81 (0.38) v 1.97 (0.43) ml/min/g; mean (SD)), the CPT-induced MBF increase (DeltaMBF) was significantly less in diabetic patients than in controls (0.07 (0.07) v 0.25 (0.12) ml/min/g; p<0.001). Treatment with glyburide and metformin significantly decreased plasma glucose concentrations from 207 (76) to 134 (52) mg/dl (p<0.001). This decrease in plasma glucose was paralleled by a significant increase in DeltaMBF in response to CPT (0.20 (0.16) from 0.07 (0.07) ml/min/g; p<0.001), which tended to be lower than in controls at baseline (0.20 (0.16) v 0.25 (0.12) ml/min/g; p = NS). The decrease in plasma glucose concentrations correlated significantly with the improvement in DeltaMBF in response to CPT (r = 0.67, p<0.01). CONCLUSIONS: Type 2 diabetes mellitus is associated with abnormal MBF response to CPT, which can be significantly improved by euglycaemic control with glyburide and metformin. The close association between the decrease in plasma glucose concentration and the improvement in coronary vasomotor function in response to CPT suggests a direct adverse effect of raised plasma glucose concentration on diabetes-related coronary vascular disease.
Keywords
Blood Glucose/metabolism
Blood Pressure/drug effects
Case-Control Studies
Coronary Circulation/drug effects
Coronary Disease/*drug therapy/physiopathology
Diabetes Mellitus, Type 2/*drug therapy/physiopathology
Diabetic Angiopathies/*drug therapy/physiopathology
Female
Glyburide/therapeutic use
Heart Rate/drug effects
Humans
Hypoglycemic Agents/*therapeutic use
Male
Metformin/therapeutic use
Middle Aged
Pubmed
Web of science
Create date
29/01/2008 16:38
Last modification date
20/08/2019 16:13