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Title

Improvement in coronary endothelial function is independently associated with a slowed progression of coronary artery calcification in type 2 diabetes mellitus

Authors
Cadenas, Jerson
Facta, Alvaro D.
Li, Yanjie
Olschewski, Manfred
Sayre, James
Goldin, Jonathan
Schelbert, Heinrich R.
Published in European Heart Journal. 2009, vol. 30, no. 24, p. 3064-3073
Abstract AIMS: To examine a relationship between alterations of structure and function of the arterial wall in response to glucose-lowering therapy in type 2 diabetes mellitus (DM) after a 1-year follow-up (FU). METHODS AND RESULTS: In DM (n = 22) and in healthy controls (n = 17), coronary artery calcification (CAC) was assessed with electron beam tomography and carotid intima-media thickness (IMT) with ultrasound, whereas coronary function was determined with positron emission tomography-measured myocardial blood flow (MBF) at rest, during cold pressor testing (CPT), and during adenosine stimulation at baseline and after FU. The decrease in plasma glucose in DM after a mean FU of 14 +/- 1.9 months correlated with a lower progression of CAC and carotid IMT (r = 0.48, P ≤ 0.036 and r = 0.46, P ≤ 0.055) and with an improvement in endothelium-related DeltaMBF to CPT and to adenosine (r = 0.46, P ≤ 0.038 and r = 0.36, P ≤ 0.056). After adjusting for metabolic parameters by multivariate analysis, the increases in DeltaMBF to CPT after glucose-lowering treatment remained a statistically significant independent predictor of the progression of CAC (P ≤ 0.001 by one-way analysis of variance). CONCLUSION: In DM, glucose-lowering treatment may beneficially affect structure and function of the vascular wall, whereas the observed improvement in endothelium-related coronary artery function may also mediate direct preventive effects on the progression of CAC.
Keywords AdultCalcinosis/*drug therapy/physiopathologyCarotid Artery Diseases/pathologyCoronary Artery Disease/*drug therapy/pathology/physiopathologyCoronary Circulation/drug effectsDiabetes Mellitus, Type 2/*drug therapy/pathology/physiopathologyDiabetic Angiopathies/*drug therapy/pathology/physiopathologyDisease ProgressionEndothelium, Vascular/physiologyFemaleHumansHypoglycemic Agents/*therapeutic useMaleMiddle AgedPositron-Emission TomographyTunica Intima/pathologyTunica Media/pathology
Identifiers
PMID: 19914919
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Research group Groupe Schindler Thomas (cardiologie) (890)
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SCHINDLER, Thomas et al. Improvement in coronary endothelial function is independently associated with a slowed progression of coronary artery calcification in type 2 diabetes mellitus. In: European Heart Journal, 2009, vol. 30, n° 24, p. 3064-3073. https://archive-ouverte.unige.ch/unige:20081

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Deposited on : 2012-04-23

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