What question did this study set out to answer?

To examine differences in resting and stress myocardial blood flow between patients with type 2 diabetes and control subjects, and to identify predictors of altered perfusion.

March 19, 2020Diabetes CareOpen Access

Reduced Myocardial Perfusion Reserve in Type 2 Diabetes Is Caused by Increased Perfusion at Rest and Decreased Maximal Perfusion During Stress

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Why the study?

Differences in myocardial blood flow at rest and during stress between patients with type 2 diabetes and control subjects, as well as predictors of these changes, needed evaluation.

Does type 2 diabetes alter myocardial blood flow at rest and during stress compared to control subjects?

Population

193 patients with type 2 diabetes and 20 age- and sex-matched control subjects

Comparison

Patients with type 2 diabetes vs age- and sex-matched control subjects

Design

Cross-sectional study

Authors

MSMartin Heyn SørensenSlagelse Hospital ABAnnemie Stege BojerHerlev Hospital JPJulie R.N. PontoppidanRegion Zealand

Discussion

Member takes

Implication

May reflect microvascular dysfunction in type 2 diabetes; leaves open prognostic value and need for prospective validation.

Key Points

To examine differences in resting and stress myocardial blood flow between patients with type 2 diabetes and control subjects, and to identify predictors of altered perfusion.
Conducted a cross-sectional study of 193 patients with type 2 diabetes and 20 age- and sex-matched control subjects.
Cardiovascular magnetic resonance was utilized to evaluate left ventricular structure, diffuse fibrosis via myocardial extracellular volume, and myocardial blood flow (MBF) at rest and during adenosine-induced stress.
Patients with type 2 diabetes exhibited higher global resting MBF (0.81 ± 0.19 vs. 0.61 ± 0.11 mL/min/g; P < 0.01) and lower stress MBF (2.4 ± 0.9 vs. 3.2 ± 0.8 mL/min/g; P < 0.01) compared with control subjects.
Stress MBF was lower in patients with macroalbuminuria (1.6 ± 0.5 mL/min/g) than microalbuminuria (2.1 ± 0.7 mL/min/g; P = 0.04) and normoalbuminuria (2.7 ± 0.9 mL/min/g; P < 0.01), with similar stepwise reductions observed across retinopathy severity (P < 0.05).
Stress-related MBF inversely correlated with diffuse myocardial fibrosis assessed by extracellular volume (R² = 0.37, P < 0.001), while albuminuria and retinopathy remained independently associated with impaired stress perfusion.

Structured PICO

Does type 2 diabetes alter myocardial blood flow at rest and during stress compared to control subjects?

Population

193 patients with type 2 diabetes and 20 age- and sex-matched control subjects

Intervention

Type 2 diabetes

Comparator

Age- and sex-matched control subjects

Outcome

Myocardial blood flow (MBF) at rest and during adenosine-induced stress measured by cardiovascular magnetic resonancesurrogate

Type 2 diabetes is associated with impaired myocardial perfusion reserve, driven by both increased resting perfusion and decreased stress perfusion, which correlates with microvascular complications and diffuse myocardial fibrosis.

Cite This Study

Sørensen et al. (2020) studied this question.

synapsesocial.com/papers/6a82073e1ece0ba82ce1ba9b https://doi.org/10.2337/dc19-2172

Topics

Echocardiography

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Reduced Myocardial Perfusion Reserve in Type 2 Diabetes Is Caused by Increased Perfusion at Rest and Decreased Maximal Perfusion During Stress

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Reduced Myocardial Perfusion Reserve in Type 2 Diabetes Is Caused by Increased Perfusion at Rest and Decreased Maximal Perfusion During Stress

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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