Related Experiment Video
Updated: Jun 19, 2026
Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice
Published on: August 25, 2023
Influence of abnormal glucose metabolism on coronary microvascular function after a recent myocardial infarction
Brian B Løgstrup1, Dan E Høfsten, Thomas B Christophersen
1Department of Medical Research, Funen Hospital, Svendborg, Denmark. bbl@dadlnet.dk
Insights
Patients with diabetes mellitus (DM) show reduced coronary flow reserve (CFR) after acute myocardial infarction (AMI). Impaired glucose tolerance did not significantly affect CFR, suggesting DM is a key factor in microvascular dysfunction post-AMI.
Area of Science:
- Cardiology
- Diabetology
- Microvascular Function
Background:
- Abnormal glucose metabolism is linked to increased mortality and morbidity post-acute myocardial infarction (AMI).
- This elevated risk may stem from impaired cardiac microcirculation, a critical aspect of heart function.
- Understanding this link is vital for improving outcomes in AMI patients.
Purpose of the Study:
- To investigate the association between abnormal glucose metabolism and coronary flow reserve (CFR) in patients recovering from AMI.
- To determine if different categories of glucose metabolism impact microvascular function after myocardial infarction.
Main Methods:
- 183 patients with a first AMI underwent oral glucose tolerance tests to categorize glucose metabolism.
- Coronary flow reserve (CFR) was assessed noninvasively using transthoracic echocardiography after revascularization.
- Adenosine infusion was used to achieve hyperemia, with CFR calculated as the ratio of hyperemic to baseline diastolic flow velocities.
Main Results:
- 60% of patients had a CFR ≤ 2, indicating abnormal microvascular function.
- Patients with a history of diabetes mellitus (DM) or newly diagnosed DM exhibited significantly lower CFR.
- Impaired glucose tolerance did not show a significant association with reduced CFR.
Conclusions:
- Coronary flow reserve (CFR) is significantly reduced in patients with known or newly diagnosed diabetes mellitus post-AMI.
- Impaired glucose tolerance does not appear to affect CFR as profoundly as diabetes.
- These findings highlight the detrimental impact of diabetes on coronary microvascular function following acute myocardial infarction.
Objectives:
This study sought to assess the association between abnormal glucose metabolism and abnormal coronary flow reserve (CFR) in patients with a recent acute myocardial infarction (AMI).
Background:
Mortality and morbidity after AMI is high among patients with abnormal glucose metabolism, which may be related to abnormal microcirculation.
Methods:
We studied 183 patients with a first AMI. In 161 patients with no history of diabetes mellitus (DM), an oral glucose tolerance test was performed, and patients were categorized according to World Health Organization criteria for whole blood glucose into 3 groups. After coronary angiography and revascularization, a comprehensive transthoracic echocardiogram and noninvasive assessment of CFR was performed in the distal part of left descending artery, as an indicator of microvascular function. Adenosine was administered by intravenous infusion (140 microg/kg/min) to obtain the hyperemic flow profiles. The CFR was defined as the ratio of hyperemic to baseline peak diastolic coronary flow velocities.
Results:
Median CFR was 1.9 (interquartile range [IQR] 1.4 to 2.4], and 109 (60%) patients had a CFR
Conclusions:
CFR is decreased in patients with known or newly diagnosed DM even after adjustment of possible confounders, whereas CFR in patients with impaired glucose tolerance seems less affected. (Coronary Flow Reserve and Glucometabolic State [CFRGS]; NCT00845468).
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:21Myocarditis I: Introduction