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[Dysfunction of the coronary microcirculation in type 2 diabetic patients]
A Nitenberg1, S Ledoux, P Valensi
1Service de physiologie et d'explorations fonctionnelles, hôpital Louis-Mourier, centre hospitalier universitaire Xavier-Bichat, Colombes.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|September 16, 2000
Summary
Diabetic patients with normal coronary arteries show impaired blood flow response to cold stress. This suggests microvascular dysfunction may contribute to heart issues in diabetes.
Area of Science:
- Cardiovascular Physiology
- Diabetic Complications
- Microvascular Function
Background:
- Coronary atherosclerosis impairs blood flow during cold stress.
- Diabetics without epicardial stenosis show impaired vasodilation.
- Diabetic microvascular dysfunction is a growing concern.
Purpose of the Study:
- To assess coronary microvascular adaptation to sympathetic stimulation in type 2 diabetics.
- To investigate diabetic patients with angiographically normal coronary arteries.
Main Methods:
- Examined 22 type 2 diabetic patients and 15 controls with normal coronary arteries.
- Used cold pressor test for sympathetic stimulation.
- Measured coronary blood flow via intracoronary Doppler and digital angiography.
Main Results:
- Diabetic patients had significantly lower coronary blood flow increase than controls.
- Rate-pressure product increase was similar between groups.
- No correlation between coronary blood flow and rate-pressure product in diabetics, unlike controls.
Conclusions:
- Coronary microcirculation vasodilatation is impaired in type 2 diabetics during sympathetic stimulation.
- This microvascular impairment may explain exercise-induced perfusion abnormalities.
- Impaired microvascular response can affect coronary vasodilation during daily stressors.