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Title

Structural alterations of the coronary arterial wall are associated with myocardial flow heterogeneity in type 2 diabetes mellitus

Authors
Facta, Alvaro D.
Prior, John O.
Cadenas, Jerson
Zhang, Xiao-Li
Li, Yanjie
Sayre, James
Goldin, Jonathan
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Published in European Journal of Nuclear Medicine and Molecular Imaging. 2009, vol. 36, no. 2, p. 219-229
Abstract 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 ≤ 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 ≤ 0.014; r = -0.46, p ≤ 0.007; and r = -0.33, p ≤ 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.
Keywords Adenosine/pharmacologyAdultCalcinosisCarotid Arteries/pathology/physiopathologyCold Temperature*Coronary CirculationCoronary Vessels/metabolism/*pathology/*physiopathologyDiabetes Mellitus, Type 2/*physiopathology/radionuclide imagingFemaleHumansMaleMiddle AgedPositron-Emission TomographyRestSympathetic Nervous System/drug effectsVasodilation/drug effects
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PMID: 18704406
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Structures
Research group Groupe Schindler Thomas (cardiologie) (890)
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SCHINDLER, Thomas et al. Structural alterations of the coronary arterial wall are associated with myocardial flow heterogeneity in type 2 diabetes mellitus. In: European Journal of Nuclear Medicine and Molecular Imaging, 2009, vol. 36, n° 2, p. 219-229. https://archive-ouverte.unige.ch/unige:20083

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Deposited on : 2012-04-23

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