Impact of diabetes mellitus on angiographically silent coronary atherosclerosis.
Constrictive remodeling occurs in significant atherosclerotic lesions of the diabetic patient, but the impact of diabetes mellitus (DM) on the angiographically normal coronary artery is still unclear. Morphometric analysis using intravascular ultrasound (IVUS) prior to intervention evaluated 54 sites in 33 DM patients and 106 in 62 non-diabetic patients. Vessel area (VA) and lumen area (LA) were measured at angiographically normal sites in the vessel. Plaque area (PA) was calculated as VA - LA. Percentage plaque area (%PA) was calculated as PA VA. Even in the angiographically normal site, mild coronary atherosclerosis was detected by IVUS in both groups. In the patients with DM, VA and LA were significantly smaller than in the non-diabetic patient (15.5 vs 17.8 mm(2), p<0.01; and 10.1 vs 12.2 mm(2), p<0.01 respectively), whereas % PA was similar (34.5 vs 31.6%). At angiographically normal sites where mild coronary atherosclerosis is detected by IVUS, the coronary artery of diabetic patients is smaller than that of the non-diabetic. These results suggest impaired compensatory enlargement or some other constrictive mechanism has already occurred in the early stages of coronary atherosclerosis in patients with DM.
Tamada
Hiroya
H
The First Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan. hio8@quartz.ocn.ne.jp
Nishikawa
Hideo
H
Mukai
Sei
S
Setsuda
Morimichi
M
Nakamura
Mamoo
M
Suzuki
Hiroyuki
H
Oonishi
Takahiro
T
Kakuta
Yutaka
Y
Yeung
Alan C
AC
Nakano
Takeshi
T
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000000981:diagnostic imaging; D006973:Hypertension / Q000000981:diagnostic imaging; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009765:Obesity; D012016:Reference Values; D012189:Retrospective Studies; D012907:Smoking; D018084:Ultrasonography, Interventional / Q000379:methods*