title: Left ventricle geometry affects coronary flow reserve in diabetic patients.
abstract: OBJECTIVE
  The aim of this study was to investigate the association between coronary flow reserve (CFR) and left ventricle (LV) geometric patterns in patients with newly-diagnosed diabetes mellitus (DM).
  
  
  METHODS
  We studied 116 patients with newly-diagnosed DM and 31 healthy control subjects. Echocardiographic examination was performed on all subjects. Four different geometric patterns were identified in diabetic patients, according to LV mass index (LVMI) and relative wall thickness (RWT) [NG: Normal geometry; CR: Concentric remodeling; EH: Eccentric hypertrophy; CH: Concentric hypertrophy]. CFR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio.
  
  
  RESULTS
  Compared with controls, CFR was decreased in diabetic patients (p<0.05). The lowest CFR values were observed in the CH group compared with control and other groups (p<0.05, for all). Also, CFR values of the CR and EH groups were lower than NG and the control group (p<0.05, for all). CFR was associated with LV geometry (r=-0.449, p=0.001), LVMI (r=-0.401, p<0.001), RWT (r=-0.247, p=0.008), HbA1c (r=-0.576, p<0.001) and mitral valve E/A ratio (r=0.239, p=0.01) in bivariate analysis. CFR was independently associated with LV geometry (ß=-0.449, p<0.001), LVMI (ß=-0.192, p=0.016), and HbA1c (ß=-0.576, p<0.001) in multivariate analysis.
  
  
  CONCLUSIONS
  CFR was impaired in newly-diagnosed DM. The degree of this deformation increases from normal geometry towards to concentric hypertrophy. This condition suggests that myocardial structural remodeling due to diabetes might be effective on CFR.
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey. gulhankalkan@yahoo.com.tr.
authors: Gülhan
authors: G
authors: Yüksel Kalkan
authors: Department of Cardiology, Kafkas University Faculty of Medicine, Kars, Turkey.
authors: Mustafa
authors: M
authors: Gür
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Zafer
authors: Z
authors: Elbasan
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Ahmet Oytun
authors: AO
authors: Baykan
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Osman
authors: O
authors: Kuloğlu
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Durmuş Yıldıray
authors: DY
authors: Şahin
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Taner
authors: T
authors: Şeker
authors: Department of Cardiology, Başkent University Faculty of Medicine, Adana Hospital, Adana, Turkey.
authors: Filiz
authors: F
authors: Ekşi Haydardedeoğlu
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Ömer
authors: Ö
authors: Şen
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Hakan
authors: H
authors: Uçar
authors: Department of Endocrinology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Sinan
authors: S
authors: Kırım
authors: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Murat
authors: M
authors: Çaylı
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003326:Coronary Circulation / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies