Endothelial dysfunction in type 2 diabetic patients with normal coronary arteries

Gargiulo, Paola; Marciano, Caterina; Savarese, Gianluigi; D’Amore, Carmen; Paolillo, Stefania; Esposito, Giovanni; Santomauro, Maurizio; Marsico, Fabio; Ruggiero, Donatella; Scala, Oriana; Marzano, Antonio; Cecere, Milena; Casaretti, Laura; Filardi, Pasquale Perrone

doi:10.1016/j.ijcard.2011.07.076

Cited by 33 publications

(37 citation statements)

References 31 publications

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“…Recently, Gargiulo et al 10 provided a substantial contribution to clarify the role of endothelial dysfunction, assessed by PAT, in systemic atherosclerotic progression; Gupta et al 20 suggested that endothelial dysfunction may reflect cardiometabolic changes in obese prediabetic patients, representing useful tool for early cardiovascular risk assessment. Moreover, in a group of patients at high risk for vascular events as patients undergo renal transplantation, we found that PAT correlates with endothelial progenitor cells and parathyroid hormone values.…”

Section: Discussionmentioning

confidence: 99%

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Peripheral-Arterial Tonometry for Assessing Endothelial Function in Relation to Dietary Habits

Cioni

Boddi

Fatini

et al. 2013

Journal of Investigative Medicine

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BackgroundPeripheral-arterial tonometry (PAT) provides, with good reproducibility, measures of nitric oxide–mediated endothelial response, which correlate with flow-mediated dilation (FMD) findings obtained by brachial artery ultrasound. Few data about the ability of exploring endothelial function by PAT in relation to dietary habits are available. The aim of this study was to evaluate natural logarithm of reactive hyperemia index (lnRHI) in subjects referred for primary prevention, in relation to classic risk factors, in particular to adherence to Mediterranean diet and red wine consumption.MethodsThe study population was composed of 95 consecutive clinically stable subjects in primary prevention for cardiovascular diseases. All subjects underwent medical questionnaire, clinical examination, and PAT for endothelial function evaluation.ResultsA significant inverse correlation between lnRHI values and body mass index (r = −0.284; P = 0.022) was found. We described a gradual reduction in lnRHI values, corresponding to the increase in the number of risk factors (0.75 [0.31–1.26], 0.66 [0.25–0.97], 0.63 [0.37–1.19], 0.48 [0.32–0.71], 0.43 [0.31–0.91], respectively, for none, 1, 2, 3, and 4 cardiovascular risk factors; P = 0.004). A significant positive correlation between score of adherence to Mediterranean diet and lnRHI values was found (r = 0.307; P = 0.002). Higher adherence to Mediterranean diet was found in subjects with lnRHI values greater than 0.40 in comparison to others (39 [27–50] vs 33 [28–45], respectively; P = 0.064). The lnRHI values were significantly higher in regular drinkers in comparison to nonregular drinkers (0.46 [0.25–0.83] vs 0.70 [0.32–1.26], respectively; P < 0.0001).Relationship between reactive hyperemia index and red wine consumption remained statistically significant even after adjustment for age, sex, body mass index, smoking habit, hypertension, and adherence to Mediterranean diet.ConclusionsOur findings strengthen the ability of PAT to evaluate alterations of endothelium response to ischemia, in relation to physiological and clinical conditions, so indicating possible usefulness to optimize and personalize risk stratification.

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Section: Discussionmentioning

confidence: 99%

“…9 To evaluate the role of endothelial response in atherosclerotic progression, further data were provided by assessing the relationships between endothelial dysfunction and coronary artery disease in diabetic and nondiabetic patients. 10 …”

mentioning

confidence: 99%

Peripheral-Arterial Tonometry for Assessing Endothelial Function in Relation to Dietary Habits

Cioni

Boddi

Fatini

et al. 2013

Journal of Investigative Medicine

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“…Findings from our study are concurring with results from Paola Gargiulo et al, who found that Diabetic patients with and without CAD show significantly impaired peripheral vascular function compared to non-diabetic patients without CAD. 26 ED in diabetic patients without CAD is comparable to patients with CAD without DM. In another study by Gissette Reyes-Soffer et al, showed patients with CAD, the concomitant presence of T2DM is independently associated with greater ED.…”

Section: Discussionmentioning

confidence: 70%

Correlation between endothelial dysfunction, inflammatory status, oxidative stress and total (nitrite/ nitrate) in subjects with diabetes mellitus type 2

Reddy

Chiranjeevi²,

Chandrasekhar

et al. 2017

Int J Basic Clin Pharmacol

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Background: Diabetes Mellitus is a systemic metabolic disorder associated with Endothelial dysfunction and increased systemic inflammatory state with oxidative stress leading to increased Cardiovascular risk. This study planned to correlate the level of Endothelial dysfunction with oxidative stress and inflammatory status.Methods: Study was conducted in 60 Diabetes Mellitus subjects of both genders with duration of more than two years. Endothelial dysfunction assessed as Augmentation Pressure and Augmentation Index generated from Radial artery waveforms by tonometer using Spygmocor PWA system. Plasma Total Nitrite/ Nitrate, High sensitive C - Reactive Protein, Malondialdehyde and Glutathione were measured.Results: Out of total 60 Diabetes Mellitus subjects 16 subjects were with Coronary Artery Disease. There was no significant difference in High sensitive C - Reactive Protein, Glutathione, Malondialdehyde and Total Nitrite/ Nitrate between Diabetes Mellitus with Coronary Artery Disease and without Coronary Artery Disease, however significant difference (p=0.02) was observed Augmentation Pressure between Diabetic alone (12.8±5.19 mm of Mercury) and diabetics with Coronary Artery Disease (16.13±33.47 mm of Mercury) and Augmentation Index (p=0.04) between Diabetic alone (29.8±5.68 mm of Mercury) and diabetics with Coronary Artery Disease (40.01±5.74). As endothelial function is age dependent the subjects were divided into three age groups (20-40 years, 40-60 years and more than 60 years). High sensitive C - Reactive Protein, Glutathione, Malondialdehyde, Total Nitrite/ Nitrate and Augmentation Index did not differ in the three age groups while Augmentation Pressure (p=0.0096) showed significant difference between age group 20-40 years (10.59±3.24) and age group more than 60 years (15.83±3.92).Conclusions: There is significant endothelial dysfunction observed in Diabetes Mellitus subjects and Diabetes Mellitus with coronary artery disease showed greater endothelial dyfunction. Thereby concluding that Diabetes Mellitus subjects were at higher risk for development of coronary artery disease and as endothelial dysfunction is an early event, it may have some prognostic value.

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“…The potential reasons of the different benefits of nicorandil in IHD patients with and without hemodialysis are not clear. It is well known that the ischemic injuries of the heart in hemodialysis patients with IHD might be induced not only by obstructive arteries but also by the increased inflammation [42,43], microvascular dysfunction [44,45], endothelial dysfunction [46][47][48][49], platelet dysfunction, thrombosis, and vasomotor dysfunction [50,51]. The biological functions of nicorandil of nitric oxide release and its antiinflammatory effects might partially explain its benefit effect in hemodialysis individuals.…”

Section: Discussionmentioning

confidence: 99%

All-cause mortality and cardiovascular events with nicorandil in patients with IHD: Systematic review and meta-analysis of the literature

Luo

et al. 2014

International Journal of Cardiology

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Endothelial dysfunction in type 2 diabetic patients with normal coronary arteries

Cited by 33 publications

References 31 publications

Peripheral-Arterial Tonometry for Assessing Endothelial Function in Relation to Dietary Habits

Peripheral-Arterial Tonometry for Assessing Endothelial Function in Relation to Dietary Habits

Correlation between endothelial dysfunction, inflammatory status, oxidative stress and total (nitrite/ nitrate) in subjects with diabetes mellitus type 2

All-cause mortality and cardiovascular events with nicorandil in patients with IHD: Systematic review and meta-analysis of the literature

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