TY - JOUR
T1 - Improvement in coronary endothelial function is independently associated with a slowed progression of coronary artery calcification in type 2 diabetes mellitus
AU - Schindler, Thomas H.
AU - Cadenas, Jerson
AU - Facta, Alvaro D.
AU - Li, Yanjie
AU - Olschewski, Manfred
AU - Sayre, James
AU - Goldin, Jonathan
AU - Schelbert, Heinrich R.
N1 - Funding Information:
This work was supported by National Heart, Lung and Blood Institute (NIH), Bethesda, Maryland [grant number: HL 33177].
PY - 2009/12
Y1 - 2009/12
N2 - 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 resultsIn 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 ΔMBF 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 ΔMBF 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).ConclusionIn 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.
AB - 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 resultsIn 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 ΔMBF 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 ΔMBF 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).ConclusionIn 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.
KW - Cardiovascular disease prevention
KW - Carotid IMT
KW - Coronary artery calcification
KW - Coronary circulation
KW - Diabetes mellitus
KW - Endothelium
KW - Positron emission tomography
UR - http://www.scopus.com/inward/record.url?scp=72649099809&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehp482
DO - 10.1093/eurheartj/ehp482
M3 - Article
C2 - 19914919
AN - SCOPUS:72649099809
SN - 0195-668X
VL - 30
SP - 3064
EP - 3073
JO - European heart journal
JF - European heart journal
IS - 24
ER -