title: Impaired coronary and retinal vasomotor function to hyperoxia in Individuals with Type 2 diabetes.
abstract: OBJECTIVE
  Adults with diabetes are at a high risk of developing coronary heart disease. The purpose of this study was to assess coronary artery vascular function non-invasively in individuals with and without Type 2 diabetes and to compare these coronary responses to another microvascular bed (i.e. retina). We hypothesized that individuals with diabetes would have impaired coronary reactivity and that these impairments would be associated with impairments in retinal reactivity.
  
  
  METHODS
  Coronary blood velocity (Transthoracic Doppler Echocardiography) and retinal diameters (Dynamic Vessel Analyzer) were measured continuously during five minutes of breathing 100% oxygen (i.e. hyperoxia) in 15 persons with Type 2 diabetes and 15 age-matched control subjects. Using fundus photographs, retinal vascular calibers were also measured (central retinal arteriole and venule equivalents).
  
  
  RESULTS
  Individuals with diabetes compared to controls had impaired coronary (-2.34±16.64% vs. -14.27±10.58%, P=0.03) and retinal (arteriole: -0.04±3.34% vs. -3.65±5.07%, P=0.03; venule: -1.65±3.68% vs. -5.23±5.47%, P=0.05) vasoconstrictor responses to hyperoxia, and smaller central arteriole-venule equivalent ratios (0.83±0.07 vs. 0.90±0.07, P=0.014). Coronary reactivity was associated with central retinal arteriole equivalents (r=-0.516, P=0.005) and retinal venular reactivity (r=0.387, P=0.034).
  
  
  CONCLUSIONS
  Diabetes impairs coronary and retinal microvascular function to hyperoxia. Impaired vasoconstrictor responses may be part of a systemic diabetic vasculopathy, which may contribute to adverse cardiovascular events in individuals with diabetes.
authors.affiliation: Penn State Hershey Medical Center, Heart and Vascular Institute, Hershey, PA 17033, USA. Electronic address: mlott@hmc.psu.edu.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Lott
authors.affiliation: John Hopkins University, Department of Biology, Baltimore, MD 21218, USA.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Slocomb
authors.affiliation: Penn State Hershey Medical Center, Heart and Vascular Institute, Hershey, PA 17033, USA.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Joslin Diabetes Center, Harvard Medical School, Boston, MA 02116, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gabbay
authors.affiliation: Penn State Hershey Medical Center, Department of Ophthalmology, Hershey, PA 17033, USA.
authors.forename: David
authors.initials: D
authors.lastname: Quillen
authors.affiliation: University of Michigan, Kellogg Eye Center, Ann Arbor, MI 48105, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Gardner
authors.affiliation: Penn State Hershey Medical Center, Department of Neurology, Hershey, PA 17033, USA.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Bettermann
mesh_terms: D000328:Adult; D000368:Aged; D001160:Arterioles / Q000473:pathology; D001794:Blood Pressure; D016022:Case-Control Studies; D003326:Coronary Circulation; D003327:Coronary Disease / Q000532:radiotherapy*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D003925:Diabetic Angiopathies / Q000473:pathology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D018496:Hyperoxia / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D012171:Retinal Vessels / Q000473:pathology
keywords: Coronary reactivity; Diabetes; Hyperoxia; Retinal reactivity; Vasoconstriction