title: Relationship between HgbA1c and myocardial blood flow reserve in patients with type 2 diabetes mellitus: noninvasive assessment using real-time myocardial perfusion echocardiography.
abstract: To study the relationship between glycosylated hemoglobin (HgbA1c) and myocardial perfusion in type 2 diabetes mellitus (T2DM) patients, we prospectively enrolled 24 patients with known or suspected coronary artery disease (CAD) who underwent adenosine stress by real-time myocardial perfusion echocardiography (RTMPE). HgbA1c was measured at time of RTMPE. Microbubble velocity (β min(-1)), myocardial blood flow (MBF, mL/min/g), and myocardial blood flow reserve (MBFR) were quantified. Quantitative MCE analysis was feasible in all patients (272/384 segments, 71%). Those with HgbA1c > 7.1% had significantly lower βreserve and MBFR than those with HgbA1c ≤ 7.1% (P < 0.05). In patients with suspected CAD, there was a significant inverse correlation between MBFR and HgbA1c (r = -0.279, P = 0.01); however, in those with known CAD, this relationship was not significant (r = -0.117, P = 0.129). Using a MBFR cutoff value > 2 as normal, HgbA1c > 7.1% significantly increased the risk for abnormal MBFR, (adjusted odds ratio: 1.92, 95% CI: 1.12-3.35, P = 0.02). Optimal glycemic control is associated with preservation of MBFR as determined by RTMPE, in T2DM patients at risk for CAD.
authors.affiliation: Mayo Clinic Cardiovascular Ultrasound and Hemodynamic Laboratory, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA ; Division of Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
authors.forename: Runqing
authors.initials: R
authors.lastname: Huang
authors.affiliation: Mayo Clinic Cardiovascular Ultrasound and Hemodynamic Laboratory, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA ; Division of Cardiovascular Medicine, Assiut University, Assiut 71515, Egypt.
authors.forename: Sahar S
authors.initials: SS
authors.lastname: Abdelmoneim
authors.affiliation: Mayo Clinic Cardiovascular Ultrasound and Hemodynamic Laboratory, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Lara F
authors.initials: LF
authors.lastname: Nhola
authors.affiliation: Mayo Clinic Cardiovascular Ultrasound and Hemodynamic Laboratory, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Mulvagh
mesh_terms: D000241:Adenosine; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D025401:Echocardiography, Stress; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012039:Regional Blood Flow; D012307:Risk Factors; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000241:Adenosine; D015415:Biomarkers; D006442:Glycated Hemoglobin; D014665:Vasodilator Agents; C517652:hemoglobin A1c protein, human
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