title: Relationship between hyperglycemia and coronary vascular resistance in non-diabetic patients.
abstract: BACKGROUND
  Hyperglycemia upon hospital admission in patients with acute myocardial infarction is associated with the no-reflow phenomenon after successful reperfusion, and increased mortality. However, the mechanism underlying this phenomenon remains unclear. Therefore, the aim of this study was to characterize coronary hemodynamics in a homogenous group of non-diabetic patients without coronary artery disease.
  
  
  RESULTS
  A total of 104 consecutive non-diabetic patients (mean age, 62+/-14 years) without coronary artery disease underwent Doppler flow study of the left anterior descending coronary artery. Vascular reactivity was examined by intra-coronary administration of papaverine, acetylcholine (Ach), and nitroglycerin using a Doppler guidewire. Coronary vascular resistance (CVR) was calculated as the mean arterial pressure divided by coronary blood flow (CBF). Baseline CVR was shown as CVR at control and minimal CVR was shown as CVR with papaverine administration. Fasting plasma glucose (FPG) level had a significant, positive correlation with baseline CVR and minimal CVR (r=0.24, p<0.02 and r=0.21, p<0.05, respectively). Hemoglobin A1c (HbA1c) also had a significant, positive correlation with baseline CVR and minimal CVR (r=0.31, p<0.01 and r=0.32, p<0.01, respectively). The percent change in CBF induced by Ach was inversely correlated with HbA1c but not with FPG (r=0.22, p<0.05 and r=0.06, p=0.57, respectively). By contrast, neither FPG nor HbA1c had significant correlation with coronary flow reserve to papaverine.
  
  
  CONCLUSIONS
  These data demonstrate that elevated glucose levels are associated with increases in baseline and minimal coronary vascular resistance. These changes may contribute to unfavorable coronary hemodynamics in non-diabetic patients without coronary heart disease.
authors.affiliation: Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ichiki
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hamasaki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nakasaki
authors.forename: Sanemasa
authors.initials: S
authors.lastname: Ishida
authors.forename: Akiko
authors.initials: A
authors.lastname: Yoshikawa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kataoka
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ogawa
authors.forename: Keishi
authors.initials: K
authors.lastname: Saihara
authors.forename: Hideki
authors.initials: H
authors.lastname: Okui
authors.forename: Koji
authors.initials: K
authors.lastname: Orihara
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinsato
authors.forename: Naoya
authors.initials: N
authors.lastname: Oketani
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shirasawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ninomiya
authors.forename: So
authors.initials: S
authors.lastname: Kuwahata
authors.forename: Shoji
authors.initials: S
authors.lastname: Fujita
authors.forename: Takuro
authors.initials: T
authors.lastname: Takumi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Iriki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Takehiko
authors.initials: T
authors.lastname: Matsushita
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000502:physiology*; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014655:Vascular Resistance / Q000502:physiology; D055815:Young Adult