Impaired coronary microvascular function in diabetics

Tsujimoto, Go

doi:10.1007/bf02987855

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…Microvascular abnormalities are present in type 2 diabetes [1,2]. Microvascular dysfunction precedes development of type 2 diabetes and is associated with insulin resistance, which characteristically predates this condition [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The insulin sensitiser pioglitazone does not influence skin microcirculatory function in patients with type 2 diabetes treated with insulin

et al. 2006

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Aims/hypothesis: Insulin resistance is associated with abnormal microvascular function. Treatment with insulin sensitisers may provoke oedema, suggesting microvascular effects. The mechanisms underlying the peripheral oedema observed during glucose-lowering treatment with thiazolidinediones are unclear. Therefore we examined the effect of pioglitazone on microvascular variables involved in oedema formation. Methods:: Subjects (40-80 years) with type 2 diabetes and on insulin were randomised to 9 weeks of pioglitazone therapy (30 mg/day; n=14) or placebo (n=15). The following assessments were performed at baseline and 9 weeks: microvascular filtration capacity; isovolumetric venous pressure; capillary pressure; capillary recruitment following venous or arterial occlusion; postural vasoconstriction; and maximum blood flow. A number of haematological variables were also measured including vascular endothelium growth factor (VEGF), IL-6 and C-reactive protein (CRP). Results: Pioglitazone did not significantly influence any microcirculatory variable as compared with placebo (analysis of covariance [ANCOVA] for microvascular filtration capacity for the two groups, p=0.26). Mean VEGF increased with pioglitazone (61.1 pg/ml), but not significantly more than placebo (9.76 pg/ml, p=0.94).HbA 1c levels and the inflammatory markers IL-6 and CRP decreased with pioglitazone compared with placebo (ANCOVA: p=0.009, p=0.001 and p=0.004, respectively). Conclusions/interpretation: Pioglitazone improved glycaemic control and inflammatory markers over 9 weeks but had no effect on microcirculatory variables associated with oedema or insulin resistance in type 2 diabetic patients treated with insulin.

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Section: Introductionmentioning

confidence: 99%

The insulin sensitiser pioglitazone does not influence skin microcirculatory function in patients with type 2 diabetes treated with insulin

et al. 2006

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“…Though quantification of MBF with SPECT has been studied in small cohorts of patients, [21][22][23] there is certainly a dearth of data regarding its prognostic value. There have also been a few doubts raised regarding the technique itself.…”

Section: Microvascular Disease-myth or Realitymentioning

confidence: 99%

Abnormal myocardial perfusion in the absence of anatomically significant coronary artery disease: Implications and clinical significance

Venuraju

Yerramasu

Lahiri

2010

Journal of Nuclear Cardiology

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“…Considerando os aspectos cintilográficos, os resultados da CMP normais tiveram índice baixo de eventos (1 a 2%/ano), com resultados pouco alterados, risco intermediá-rio (3 a 4%/ano) e elevada taxa de eventos (>7%/ano) naqueles com alterações moderadas e acentuadas. Avaliou-se a circulação microvascular nos diabéticos 62 pela medida no % de aumento da captação miocárdica do traçador (tetrofosmin) entre as imagens de repouso e exercício, encontrando diferença significativa entre o grupo de diabéticos versus o não diabético. Hurrel e cols.…”

Section: Avaliação Terapêuticaunclassified