Key result
LQHTHX significantly attenuated cardiomyocyte pathological injury, reduced microvascular thrombosis, and inhibited apoptosis in rats with coronary microvascular dysfunction.
p-value: p=<0.001
This editorial refers to ‘Incremental prognostic value of positron emission tomography-derived myocardial flow reserve in patients with and without diabetes mellitus', by A. Aljizeeri et al., https://doi.org/10.1093/ehjci/jead023. Type 1 and Type 2 diabetes mellitus (DM) is commonly accompanied by an early initiation and/or acceleration of the coronary artery disease (CAD) process that likely accounts for previously reported excess of morbidity and mortality in these patients.1 As adverse effects of DM on the autonomic nervous system may hamper the manifestation of symptoms such as chest pain, dyspnoea, or fatigue, DM patients are prone to silent ischaemia leading to a significant delay in advanced stages of CAD associated with a worse clinical outcome when compared with non-DM patients.1 Notably, the proof of advanced stages of CAD with haemodynamic obstruction of stress-induced hyperaemic flow increases with scintigraphy myocardial perfusion imaging (MPI) in DM is associated with a significantly worse clinical outcome, in particular in women and Type 1 DM, when compared with similar stages of CAD in patients without DM.2 Regarding the presence of silent ischaemia in CAD, the DIAD (Detection of Ischemia in Asymptomatic Diabetes) was conducted in order to assess outcome after screening for asymptomatic CAD in patients with Type 2 diabetes.3 In the randomized controlled DIAD screening population, myocardial perfusion scintigraphy was indeed able to accurately prognosticate cardiovascular risk with higher event rates in patients with moderate or large perfusion deficits when compared with those with only mildly abnormal or normal myocardial perfusion findings. Conversely, in the DIAD study, a low prevalence of patients with high-risk MPI abnormalities was observed, providing some rationale why screening did not unravel any difference on outcome compared with aggressive medical treatment.3 With the increasing use of cardiac positron emission tomography (PET) to measure not only myocardial perfusion but also concurrently myocardial blood flow (MBF) in mL/g/min during pharmacologic stress and at rest with corresponding myocardial flow reserve (MFR), the non-invasive assessment of coronary microvascular dysfunction (CMD) has become feasible in clinical practice and cardiovascular care.4–6 Numerous cardiac PET flow studies7,8 have demonstrated an incremental prognostic value of abnormal reductions in MFR in patients with clinically manifest and subclinical CAD.
No takes yet. Share an insight, caveat, or question.
Schindler et al. (2023) studied Coronary microvascular dysfunction (n=64). LQHTHX vs. Vehicle (0.5% CMC-Na), Nicorandil, or Valsartan was evaluated on Myocardial apoptosis and microvascular thrombosis (p=<0.001). LQHTHX significantly attenuated cardiomyocyte pathological injury, reduced microvascular thrombosis, and inhibited apoptosis in rats with coronary microvascular dysfunction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: