Diabetic background retinopathy is associated with impaired coronary vasoreactivity in people with Type 1 diabetes |
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| Authors: | J.?Sundell author-information" > author-information__contact u-icon-before" > mailto:jan.sundell@utu.fi" title=" jan.sundell@utu.fi" itemprop=" email" data-track=" click" data-track-action=" Email author" data-track-label=" " >Email author,T.?Janatuinen,T.?R?nnemaa,O.?T.?Raitakari,J.?Toikka,P.?Nuutila,J.?Knuuti |
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| Affiliation: | (1) Turku PET Centre, Turku University Central Hospital, P.O. Box 52, 20521 Turku, Finland;(2) Department of Medicine, University of Turku, Turku, Finland;(3) Department of Clinical Physiology, University of Turku, Turku, Finland |
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| Abstract: | Aims/hypothesis We examined whether diabetic background retinopathy is associated with reduced coronary vasoreactivity in people with Type 1 diabetes.Methods A total of 21 men with Type 1 diabetes were investigated, including 9 men with background retinopathy and 12 men without retinopathy. In addition, 12 non-diabetic, age-matched subjects were studied. All subjects were non-smokers, otherwise healthy and had no other diabetic complications. Resting myocardial blood flow and hyperaemic dipyridamole-stimulated flow (dipyridamole, 0.56 mg/kg during a 4-min period), a measure of coronary vasoreactivity, were measured during euglycaemic hyperinsulinaemic clamp (1 mU·kg–1·min–1) using positron emission tomography and oxygen-15-labelled water.Results Resting myocardial blood flow (0.82±0.13 vs 0.96±0.23 vs 0.88±0.25 ml·g–1·min–1, with vs without retinopathy vs non-diabetic subjects) and coronary vascular resistance (111.2±23.4 vs 95.5±15.8 vs 101.9±31.5 mmHg·min·g·ml–1 respectively) were not significantly different between the groups. Dipyridamole infusion induced an increase in blood flow and a decrease in coronary vascular resistance in all study subjects (p<0.001). However, dipyridamole-stimulated flow and coronary vascular resistance were blunted in diabetic patients with retinopathy (2.9±0.9 ml·g–1·min–1 and 34.1±11.3 mmHg·min·g·ml–1) when compared to diabetic patients without retinopathy (4.0±1.3 ml·g–1·min–1, p=0.04 and 24.6±7.5 mmHg·min·g·ml–1, p=0.03) or non-diabetic subjects (4.5±1.4 ml·g–1·min–1, p=0.008 and 22.2±8.7 mmHg·min·g·ml–1, p=0.01). Myocardial flow reserve was impaired in diabetic patients with retinopathy (3.6±1.0) when compared to non-diabetic subjects (5.3±1.9, p=0.02) but not significantly reduced when compared to diabetic patients without retinopathy (4.2±1.4, p=0.2).Conclusions/interpretation Diabetic background retinopathy appears to be associated with impaired coronary vasoreactivity in young people with Type 1 diabetes.Abbreviations PET positron emission tomography - [15O]H2O oxygen-15-labelled waterJ. Sundell and T. Janatuinen contributed equally to this work |
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| Keywords: | Myocardial blood flow Type 1 diabetes Retinopathy Dipyridamole Positron emission tomography |
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