Short-term oral treatment with the angiotensin II receptor antagonist losartan does not improve coronary vasomotor function in asymptomatic type 2 diabetes patients.
BACKGROUND
We have previously found that acute intravenous infusion of an ACE inhibitor normalized the reduced coronary vasomotor function in type 2 diabetes. The aim of the present study was to extend this investigation to an angiotensin II receptor blocker (ARB) administered orally in normotensive, asymptomatic type 2 diabetes patients without albuminuria.


RESULTS
Fourteen type 2 diabetes patients were included. Each patient had myocardial perfusion measured by PET at three occasions: at baseline, following 3 weeks of treatment with 50mg/d and following another 3 weeks of treatment with 100mg/d of losartan. Baseline myocardial perfusion was similar at all three sessions (0.89+/-0.05, 0.90+/-0.08 and 0.84+/-0.05mL/(ming) tissue, respectively). Likewise, maximal hyperaemic perfusion after i.v. dipyridamole (0.56mg/kg bwt) was low but similar at the three sessions (2.01+/-0.14, 2.05+/-0.17 and 1.90+/-0.20mL/(ming) tissue, respectively). Myocardial perfusion reserve, i.e. maximal hyperaemic flow relative to baseline flow, was also low, but similar before and after treatment with losartan (2.36+/-0.24, 2.44+/-0.24 and 2.62+/-0.42mL/(ming) tissue, respectively).


CONCLUSIONS
Oral treatment with an ARB did not normalize coronary vasomotor function in type 2 diabetes patients without cardiovascular disease.
Kjaer
Andreas
A
Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Denmark. kjaer@mfi.ku.dk
Kristoffersen
Ulrik Sloth
US
Tarnow
Lise
L
Parving
Hans-Henrik
HH
Hesse
Birger
B
D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography
D047228:Angiotensin II Type 1 Receptor Blockers; D019808:Losartan