2011
DOI: 10.1152/ajpheart.00615.2011
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Abstract: A reduced coronary flow reserve (CFR) has been demonstrated in diabetes, but the underlying mechanisms are unknown. We assessed thermodilution-derived CFR after 5-min intravenous adenosine infusion through a pressure-temperature sensor-tipped wire in 30 coronary arteries without significant lumen reduction in 30 patients: 13 with and 17 without a history of diabetes. We determined CFR as the ratio of basal and hyperemic mean transit times (T(mn)); fractional flow reserve (FFR) as the ratio of distal and proxim… Show more

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Cited by 57 publications
(64 citation statements)
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“…In order to lower heart rate during the CT scans, ivabradine was given to T1DM patients, while metoprolol was given to controls, and this might also have affected the results. However correcting for heart rate in the multivariable analysis did not change the results and our findings of higher resting perfusion in patients with diabetes are supported by other studies previous mentioned in this article [7,9]. When betablockage was given to the controls, this could leave the alpha-vasoconstrictor effect unopposed, which may in its turn have reduced myocardial blood flow in the controls.…”
Section: Limitationssupporting
confidence: 86%
See 1 more Smart Citation
“…In order to lower heart rate during the CT scans, ivabradine was given to T1DM patients, while metoprolol was given to controls, and this might also have affected the results. However correcting for heart rate in the multivariable analysis did not change the results and our findings of higher resting perfusion in patients with diabetes are supported by other studies previous mentioned in this article [7,9]. When betablockage was given to the controls, this could leave the alpha-vasoconstrictor effect unopposed, which may in its turn have reduced myocardial blood flow in the controls.…”
Section: Limitationssupporting
confidence: 86%
“…Previous studies in small groups of T1DM patients have shown a lower myocardial perfusion reserve compared with healthy controls. [5,7,8] In patients with type 2 diabetes (T2DM) a lower flow reserve was found to be due to an increased coronary blood flow at rest [9]. Whether this also apply to T1DM is unsettled.…”
Section: Introductionmentioning
confidence: 99%
“…One explanation is the potential impact of diffuse epicardial CAD and microvascular disease on FFR and the prognosis of patients with DM and CAD. [21][22][23] Individually non-flow-limiting lesions can result in a significant pressure in aggregation whereas structural and functional changes of the coronary microcirculation may not allow for sufficient flow acceleration to mount a significance pressure drop. 24,25 Another explanation might be a difference in plaque vulnerability.…”
Section: Dm and Dmmentioning
confidence: 99%
“…These findings are in keeping with previous reports on higher baseline velocities resulting in diminished flow reserve. [13][14][15] The authors of the present study shed new light on the potential mechanism of microvascular dysfunction by demonstrating that baseline and not hyperemic myocardial resistance is elevated in this cohort, leading them to hypothesize that it is related to impaired basal coronary autoregulation as opposed to reduced vasodilator reserve. This seems like a reasonable hypothesis.…”
Section: Circ Cardiovasc Intervmentioning
confidence: 74%