A1 Refereed original research article in a scientific journal
Diabetic background retinopathy is associated with impaired coronary vasoreactivity in people with Type 1 diabetes
Authors: Sundell J, Janatuinen T, Ronnemaa T, Raitakari OT, Toikka J, Nuutila P, Knuuti J
Publisher: SPRINGER-VERLAG
Publication year: 2004
Journal: Diabetologia
Journal name in source: DIABETOLOGIA
Journal acronym: DIABETOLOGIA
Volume: 47
Issue: 4
First page : 725
Last page: 731
Number of pages: 7
ISSN: 0012-186X
DOI: https://doi.org/10.1007/s00125-004-1340-8
Abstract
Aims/hypothesis. We examined whether diabetic background retinopathy is associated with reduced coronary vasoreactivity in people with Type 1 diabetes.Methods. A total of 21 men with Type 1 diabetes were investigated, including 9 men with background retinopathy and 12 men without retinopathy. In addition, 12 non-diabetic, age-matched subjects were studied. All subjects were non-smokers, otherwise healthy and had no other diabetic complications. Resting myocardial blood flow and hyperaemic dipyridamole-stimulated flow (dipyridamole, 0.56 mg/kg during a 4-min period), a measure of coronary vasoreactivity, were measured during euglycaemic hyperinsulinaemic clamp (1 mU.kg(-1).min(-1)) using positron emission tomography and oxygen-15-labelled water.Results. Resting myocardial blood flow (0.82+/-0.13 vs 0.96+/-0.23 vs 0.88+/-0.25 ml.g(-1).min(-1), with vs without retinopathy vs non-diabetic subjects) and coronary vascular resistance (111.2+/-23.4 vs 95.5+/-15.8 vs 101.9+/-31.5 mmHg.min.g.ml(-1) respectively) were not significantly different between the groups. Dipyridamole infusion induced an increase in blood flow and a decrease in coronary vascular resistance in all study subjects (p<0.001). However, dipyridamole-stimulated flow and coronary vascular resistance were blunted in diabetic patients with retinopathy (2.9+/-0.9 ml.g(-1).min(-1) and 34.1+/-11.3 mmHg.min(.)g.ml(-1)) when compared to diabetic patients without retinopathy (4.0+/-1.3 ml.g(-1).min(-1), p=0.04 and 24.6+/-7.5 mmHg.min.g.ml(-1), p=0.03) or non-diabetic subjects (4.5+/-1.4 ml.g(-1).in(-1), p=0.008 and 22.2+/-8.7 mmHg.min.g.ml(-1), p=0.01). Myocardial flow reserve was impaired in diabetic patients with retinopathy (3.6+/-1.0) when compared to non-diabetic subjects (5.3+/-1.9, p=0.02) but not significantly reduced when compared to diabetic patients without retinopathy (4.2+/-1.4, p=0.2).Conclusions/interpretation. Diabetic background retinopathy appears to be associated with impaired coronary vasoreactivity in young people with Type 1 diabetes.
Aims/hypothesis. We examined whether diabetic background retinopathy is associated with reduced coronary vasoreactivity in people with Type 1 diabetes.Methods. A total of 21 men with Type 1 diabetes were investigated, including 9 men with background retinopathy and 12 men without retinopathy. In addition, 12 non-diabetic, age-matched subjects were studied. All subjects were non-smokers, otherwise healthy and had no other diabetic complications. Resting myocardial blood flow and hyperaemic dipyridamole-stimulated flow (dipyridamole, 0.56 mg/kg during a 4-min period), a measure of coronary vasoreactivity, were measured during euglycaemic hyperinsulinaemic clamp (1 mU.kg(-1).min(-1)) using positron emission tomography and oxygen-15-labelled water.Results. Resting myocardial blood flow (0.82+/-0.13 vs 0.96+/-0.23 vs 0.88+/-0.25 ml.g(-1).min(-1), with vs without retinopathy vs non-diabetic subjects) and coronary vascular resistance (111.2+/-23.4 vs 95.5+/-15.8 vs 101.9+/-31.5 mmHg.min.g.ml(-1) respectively) were not significantly different between the groups. Dipyridamole infusion induced an increase in blood flow and a decrease in coronary vascular resistance in all study subjects (p<0.001). However, dipyridamole-stimulated flow and coronary vascular resistance were blunted in diabetic patients with retinopathy (2.9+/-0.9 ml.g(-1).min(-1) and 34.1+/-11.3 mmHg.min(.)g.ml(-1)) when compared to diabetic patients without retinopathy (4.0+/-1.3 ml.g(-1).min(-1), p=0.04 and 24.6+/-7.5 mmHg.min.g.ml(-1), p=0.03) or non-diabetic subjects (4.5+/-1.4 ml.g(-1).in(-1), p=0.008 and 22.2+/-8.7 mmHg.min.g.ml(-1), p=0.01). Myocardial flow reserve was impaired in diabetic patients with retinopathy (3.6+/-1.0) when compared to non-diabetic subjects (5.3+/-1.9, p=0.02) but not significantly reduced when compared to diabetic patients without retinopathy (4.2+/-1.4, p=0.2).Conclusions/interpretation. Diabetic background retinopathy appears to be associated with impaired coronary vasoreactivity in young people with Type 1 diabetes.
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