Abstract 13865: Relation Between Endothelial Function and Exercise-induced Myocardial Ischemia in Type 2 Diabetic Patients
Purpose: A significant number of asymptomatic patients with type 2 diabetes mellitus (T2DM) develops significant ST-segment depression (STD) (>1 mm) during exercise stress test (EST), suggesting myocardial ischemia (MI) related to either macrovascular or microvascular coronary artery disease. Aim of this study was to assess whether there is any relation between endothelial dysfunction and EST-induced myocardial ischemia in this kind of patients.
Methods: We studied 100 non insulin-dependent T2DM patients (age 62.7±8.8 years, 68 M) without any symptom or evidence of cardiovascular disease. All patients underwent a symptom/sign limited EST and assessment of the endothelium-dependent function through measurement of flow-mediated dilation (FMD) following 5-minute forearm ischemia of the right brachial artery. Endothelium-independent function was also assessed through nitrate-mediated dilation (NMD) of the right brachial artery in response to sublingual administration of 25 μg of nitroglycerin.
Results: STD (horizontal or downsloping STD >1 mm) during EST was induced in 22 patients (22%, group 1), whereas 78 (78%, group 2) showed normal ECG during the test. No differences in age, gender, cardiovascular risk factors, drug therapy, blood glucose and glycated haemoglobin levels were observed between the 2 groups. However, group 1 patients, compared to group 2, showed significantly lower values of both FMD (3.7±0.7 vs. 5.2±1.6 %, respectively, p<0.001) and NMD (11.2±1.3 vs. 11.8±1 %, respectively, p=0.015).
Conclusions: Our data suggest that in asymptomatic T2DM patients without any evidence of cardiovascular disease both endothelium-dependent and endothelium-independent vascular dysfunction are impaired in those with evidence of exercise-induced myocardial ischemia, suggesting that they can play a significant role in this abnormal finding.
Author Disclosures: L. Branca: None. G. Russo: None. A. Villano: None. M. Wu: None. F. Spera: None. L. Tanese: None. A. Rizzi: None. D. Pitocco: None. A. Di Franco: None. G.A. Lanza: None. F. Crea: None.
- © 2014 by American Heart Association, Inc.