Relationship between HgbA1c and Myocardial Blood Flow Reserve in Patients with Type 2 Diabetes Mellitus: Noninvasive Assessment Using Real-Time Myocardial Perfusion Echocardiography

Huang, Runqing; Abdelmoneim, Sahar S.; Nhola, Lara F.; Mulvagh, Sharon L.

doi:10.1155/2014/243518

Cited by 16 publications

(7 citation statements)

References 22 publications

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“…10 ). In diabetic patients, a normal CFR is associated with tighter glycemic control [ 153 ] and better long-term event-free survival both considering unselected patients [ 146 , 154 ] and patients with angiographically normal coronary arteries [ 151 ] (Fig. 9 ).…”

Section: Coronary Flow Reservementioning

confidence: 99%

The clinical use of stress echocardiography in ischemic heart disease

Sicari

Cortigiani²

2017

Cardiovasc Ultrasound

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Stress echocardiography is an established technique for the assessment of extent and severity of coronary artery disease. The combination of echocardiography with a physical, pharmacological or electrical stress allows to detect myocardial ischemia with an excellent accuracy. A transient worsening of regional function during stress is the hallmark of inducible ischemia. Stress echocardiography provides similar diagnostic and prognostic accuracy as radionuclide stress perfusion imaging or magnetic resonance, but at a substantially lower cost, without environmental impact, and with no biohazards for the patient and the physician.The evidence on its clinical impact has been collected over 35 years, based on solid experimental, pathophysiological, technological and clinical foundations. There is the need to implement the combination of wall motion and coronary flow reserve, assessed in the left anterior descending artery, into a single test. The improvement of technology and in imaging quality will make this approach more and more feasible. The future issues in stress echo will be the possibility of obtaining quantitative information translating the current qualitative assessment of regional wall motion into a number. The next challenge for stress echocardiography is to overcome its main weaknesses: dependance on operator expertise, the lack of outcome data (a widesperad problem in clinical imaging) to document the improvement of patient outcomes. This paper summarizes the main indications for the clinical applications of stress echocardiography to ischemic heart disease.

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Section: Coronary Flow Reservementioning

confidence: 99%

The clinical use of stress echocardiography in ischemic heart disease

Sicari

Cortigiani²

2017

Cardiovasc Ultrasound

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“…Several studies have shown that HgbA 1c is associated with the severity and progression of coronary atherosclerosis [29,30]. One clinical study conducted by R. Huang et al aiming to scrutinize the relationship between HbA 1c and myocardial perfusion in patients with T2DM showed that optimal glycemic control is associated with a preservation of myocardial blood ow reserve (MBFR) in T2DM patients who are at risk for CAD [31]. In this study, HbA1C was the independent risk factor for new-onset hypertension in T2DM patients.…”

Section: Discussionmentioning

confidence: 99%

Long-term Physical Activity Decreased the Risk of New-onset Hypertension in Type 2 Diabetes Mellitus Patients with Pre-hypertension: A Retrospective Cohort Study

Zhou

et al. 2022

Preprint

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Background Numerous studies were demonstrated the inverse relationship between all kinds of physical activity (PA) and cardiovascular diseases (CVDs), few of them focus on the new-onset hypertension. Therefore, this study was aimed to determine the impact of long-term PA on the risk of new-onset hypertension in type 2 diabetes mellitus (T2DM) patients with pre-hypertension.Methods A total of 268 T2DM patients with pre-hypertension were recruited between January and December 2015, and followed them up until December 2020. All patients were took PA self-assessment. Demographic, clinical, laboratory, radiologic, treatments, complications, lifestyle and clinical outcomes data were extracted from electronic medical records or collected through a structured interview.Results During 5 year follow-up, the incidence of new-onset hypertension was significantly lower in PA group (15.5% vs 35.4%, p<0.01) when compared to the inactivity group. Logistic regression analysis showed that PA (OR 0.337, 95%CI 0.168 to 0.677, p<0.01), body mass index (BMI) (OR 1.138, 95%CI 1.019 to 1.272, p<0.05) and glycosylated hemoglobin (HbA1C) (OR 1.206, 95%CI 1.006 to 1.446, p<0.05) were associated to the incidence of new-onset hypertension in pre-hypertensive T2DM patients. Subgroup analysis found that for those overweight and blood glucose poor controlled pre-hypertensive T2DM patients, long-term PA were less likely to develop hypertension (overweight: OR 0.187, 95%CI 0.063 to 0.558, p<0.01; glucose poor controlled: OR 0.349, 95%CI 0.138 to 0.880, p<0.05).Conclusion These results suggested that long-term PA might be an important protective factor for new-onset hypertension in overweight and poor blood glucose controlled pre-hypertensive T2DM patients.

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“…31 Similarly, Voulgari supported this view by demonstrating that good glycemic control was associated with a lower incidence of DCM. 32 In addition, Runqing et al 33 observed that when the microcirculation is irreversibly affected by glycemic elevation, strict glycemic control may not be beneficial. Thus, MCE demonstrated the unique potential to evaluate the microvascular function of T2DM patients receiving treatments targeted to HbA1C for the prevention of LVDD.…”

Section: Discussionmentioning

confidence: 99%