Improvement in coronary vascular dysfunction produced with euglycaemic control in patients with type 2 diabetes

• Published in: Heart (British Cardiac Society) 2007-03, Vol.93 (3), p.345-349
• Main Authors: Schindler, T H, Facta, A D, Prior, J O, Cadenas, J, Hsueh, W A, Quinones, M J, Schelbert, H R
• Format: Article
• Language: English
• Subjects: Bioavailability; Biological and medical sciences; Blood Glucose - metabolism; Blood Pressure - drug effects; Cardiology. Vascular system; Cardiovascular disease; Case-Control Studies; Cholesterol; Cold; cold pressor testing; Coronary Circulation - drug effects; coronary disease; Coronary Disease - drug therapy; Coronary Disease - physiopathology; Coronary heart disease; Coronary vessels; CPT; Diabetes; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Diabetes, Lipids and Metabolism; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - drug therapy; Diabetic Angiopathies - physiopathology; Diabetic neuropathy; Drugs; Electrocardiography; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Endothelium; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Glucose; Glyburide - therapeutic use; Health care; Heart; Heart rate; Heart Rate - drug effects; Hormone replacement therapy; Humans; Hypoglycemic Agents - therapeutic use; Insulin; Insulin resistance; Kinases; LDL; Lipoproteins; low-density lipoprotein; Male; MBF; Medical sciences; Metformin - therapeutic use; Middle Aged; Mortality; myocardial blood flow; Nitric oxide; Nutrition research; positron emission tomography; rate–pressure product; RPP; Tomography; Triglycerides; type 2 diabetes
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.2006.094128

Objective: To determine the effect of plasma glucose lowering on coronary circulatory function in type 2 diabetes mellitus. Methods: Twenty patients with type 2 diabetes and 18 weight-matched controls were studied. At baseline, myocardial blood flow (MBF) was measured with [13N]ammonia and positron emission tomography at rest, during cold pressor testing (CPT), and during adenosine hyperaemia. In diabetic patients, MBF and blood chemistry were analysed again after 3 months of glucose-lowering treatment with glyburide and metformin. Results: Although hyperaemic MBF did not differ significantly between the patients and controls (1.81 (0.38) v 1.97 (0.43) ml/min/g; mean (SD)), the CPT-induced MBF increase (ΔMBF) was significantly less in diabetic patients than in controls (0.07 (0.07) v 0.25 (0.12) ml/min/g; p