title: Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during angioplasty.
abstract: OBJECTIVE
  To test whether type II diabetes prevents the recruitment of collaterals and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty.
  
  
  METHODS
  Two groups of patients were studied. A collateral circulation group consisted of 56 patients, 18 diabetic and 38 non-diabetic. All underwent a minimum of three balloon inflations. A pressure guide wire was used for the measurement of coronary wedge pressure (mm Hg). The angioplasty protocol was repeated in another group of 57 patients (myocardial ischaemia group) using both surface and intracoronary ECGs to assess myocardial ischaemia.
  
  
  RESULTS
  In diabetic patients, mean (SD) coronary wedge pressure was 35 (12) mm Hg during the first balloon inflation, 39 (15) mm Hg during the second (p < 0.05 v first inflation), and 42 (17) mm Hg during the third (p < 0.05 v first inflation); in non-diabetic patients the respective values were 36 (16), 37 (16), and 37 (16) mm Hg (F = 4.73, p = 0.01). The ratio of coronary wedge pressure to mean arterial pressure in diabetic patients in the three balloon inflations was 0.33 (0.11), 0.36 (0.13), and 0.39 (0.15), respectively (p < 0.05 v the first inflation); and in non-diabetic patients it was 0.33 (0.15), 0.34 (0.15), and 0.35 (0.15) (F = 1.92, p = 0.15). In the diabetic group the response was independent of the type of treatment. No difference between diabetic and non-diabetic patients was observed in the normal reduction of myocardial ischaemia on repeated balloon inflations.
  
  
  CONCLUSIONS
  Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty in single vessel disease, regardless of the type of antidiabetic treatment.
authors.affiliation: Second Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece. zskyr@otenet.gr
authors.forename: Z S
authors.initials: ZS
authors.lastname: Kyriakides
authors.forename: S
authors.initials: S
authors.lastname: Psychari
authors.forename: N
authors.initials: N
authors.lastname: Chrysomallis
authors.forename: M
authors.initials: M
authors.lastname: Georgiadis
authors.forename: E
authors.initials: E
authors.lastname: Sbarouni
authors.forename: D T
authors.initials: DT
authors.lastname: Kremastinos
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D001794:Blood Pressure; D003097:Collateral Circulation / Q000502:physiology*; D023921:Coronary Stenosis / Q000503:physiopathology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology* / Q000628:therapy