Abstract 6094: Alterations in Blood Flow Reserve Secondary to Decompensated Diabetes Mellitus - Preliminary Results Obtained by Myocardial Contrast Echocardiography
Diabetes mellitus (DM) is one of the most important health problems in developed countries. Poor blood glucose control is known to be associated with clinical symptoms and increased risk for cardiovascular complications. Myocardial contrast echocardiography (MCE) has been demonstrated to be valuable for assessing myocardial blood flow reserve (MBFR) in patients with obstructive coronary artery disease and in those with microcirculatory alterations. We hypothesized that DM would result in impairment of MBFR, as measured by MCE, even in patients without obstructive coronary artery disease.
Methods: We studied 30 patients with DM (mean age 55 years, 13 men) and 10 control subjects (mean age 53 years, 5 men) with normal global and regional systolic function. MBFR was determined by quantitative contrast echocardiography during dipyridamol (0.84 mg/Kg) stress using intravenous commercialy available microbubbles contrast (Definity, Bristol-Myers Squibb). Diabetic patients were studied in a decompensated state, with mean glycosylated hemoglobin of 9.0% (ranging from 8.5% to 13.0%). Quantification of peak myocardial intensity (A), microbubble velocity (Beta) and MBFR (peak dipyridamol/baseline AxBeta) were measured off line using Q-Lab software (Philips Medical Imaging). All patients underwent computed tomography coronary angiography (64 slices) which demonstrated no obstructive coronary artery disease.
Results: Values of A (dB), Beta (1/s), and AxBeta (dB/s) both at baseline and during dipyridamol stress are described in Table⇓. MBFR was significantly lower in patients with decompensated DM than in control subjects (1.58 versus 2.87; p<0.001).
Conclusion: These preliminary results suggest that diabetic patients with poor blood glucose control and no obstructive coronary artery disease have impaired MBFR. MCE may be a useful noninvasive technique for evaluating changes in MBFR in this group of patients.