Arterial Endothelial Dysfunction and Myocardial Ischemia in Patients With Carbohydrate Metabolism Disturbances

Abstract

Aim. To assess the role of vasomotor dysfunction and impaired flowdependent vasodilatation as a risk factor of silent myocardial ischemia (SMI) in patients with Type 2 diabetes mellitus (DM-2).Material and methods. The study included 128 patients (66 men and 62 women; mean age 59,3±4,7 years), who underwent Holter ECG monitoring, stress test (Bruce protocol), echocardiography, vascular ultrasound, and brachial artery endothelium-dependent vasodilatation (EDVD) assessment.Results. Patients with coronary heart disease and DM-2 demonstrated reduced EDVD levels (3,7±1,1%) and highly prevalent SMI (93,3%). There was a correlation between EDVD and the number (r=–0,68; p<0,05) or duration of SMI episodes (r=–0,53; p<0,01).Conclusion. Patients with DM-2 require the assessment of vasomotor endothelial function in order to predict cardiovascular complications. Coronary artery endothelial dysfunction, which manifests in inadequate vasodilatation in response to increased myocardial demand for oxygen, plays an important role in the ischemia development and progression.