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Diabetes mellitus and coronary microvascular function in asymptomatic patients with severe aortic stenosis and nonobstructed coronary arteries.
- Source :
-
Diabetes & vascular disease research [Diab Vasc Dis Res] 2016 May; Vol. 13 (3), pp. 220-7. Date of Electronic Publication: 2016 Mar 18. - Publication Year :
- 2016
-
Abstract
- Background and Aim: Coronary flow reserve is impaired in asymptomatic patients with aortic stenosis and has a prognostic value. We investigated whether the type II diabetes mellitus additionally impairs microvascular circulation assessed by coronary flow reserve in patients with asymptomatic severe aortic stenosis, normal left ventricular ejection fraction and nonobstructed coronary arteries.<br />Methods: A total of 128 patients, mean age of 66.35 ± 10.51 (58.6% males), with severe aortic stenosis and normal left ventricular ejection fraction were enrolled in this study. Patients with diabetes mellitus, those who were treated for diabetes mellitus or had documentation confirming the diagnosis of diabetes mellitus, were considered. All patients underwent coronary angiography and had no obstructive coronary disease (defined as having no stenosis >50% in diameter), standard transthoracic Doppler-echocardiographic study and adenosine stress transthoracic echocardiography for coronary flow reserve measurement.<br />Results: Diabetes mellitus was present in 26 patients (20.31%). There was no significant difference in aortic stenosis severity between diabetic and non-diabetic patients [aortic valve area (0.81 ± 0.18 vs 0.85 ± 0.15 cm(2)) and Vmax (4.20 ± 0.57 vs 4.21 ± 0.48 m/s)]. Mean coronary flow reserve in diabetic patients was 1.98 ± 0.48, while mean coronary flow reserve in non-diabetic patients was 2.64 ± 0.54 (p < 0.01). Diabetes mellitus was independent predictor of coronary flow reserve [B = -0.636, 95% confidence interval (-0.916 to -0.368), p < 0.001].<br />Conclusion: Diabetes mellitus additionally impairs coronary microvascular function in asymptomatic patients with severe aortic stenosis and nonobstructed coronary arteries.<br /> (© The Author(s) 2016.)
- Subjects :
- Adenosine administration & dosage
Aged
Aortic Valve Stenosis diagnostic imaging
Aortic Valve Stenosis physiopathology
Asymptomatic Diseases
Case-Control Studies
Coronary Artery Disease diagnostic imaging
Coronary Artery Disease physiopathology
Coronary Vessels diagnostic imaging
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 diagnosis
Diabetic Angiopathies diagnostic imaging
Diabetic Angiopathies physiopathology
Echocardiography, Doppler
Echocardiography, Stress methods
Female
Humans
Kaplan-Meier Estimate
Male
Microvessels diagnostic imaging
Middle Aged
Prognosis
Risk Factors
Severity of Illness Index
Stroke Volume
Time Factors
Vasodilator Agents administration & dosage
Ventricular Function, Left
Aortic Valve Stenosis complications
Coronary Artery Disease etiology
Coronary Circulation
Coronary Vessels physiopathology
Diabetes Mellitus, Type 2 complications
Diabetic Angiopathies etiology
Microcirculation
Microvessels physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1752-8984
- Volume :
- 13
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Diabetes & vascular disease research
- Publication Type :
- Academic Journal
- Accession number :
- 26993497
- Full Text :
- https://doi.org/10.1177/1479164115627107