Reduced coronary collateralization in type 2 diabetic patients with chronic total occlusion.
Reduced coronary collateralization in type 2 diabetic patients with chronic total occlusion.
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DOI：
10.1186/s12933-018-0671-6
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发表时间：
2018-02-08
影响因子：
9.3
通讯作者：
Shen WF
中科院分区：
文献类型：
--
作者：
Shen Y;Ding FH;Dai Y;Wang XQ;Zhang RY;Lu L;Shen WF
冠状动脉侧支形成的程度是冠状动脉闭塞后心肌损伤严重程度和死亡率的主要决定因素。2型糖尿病（T2DM）是侧支血管生长受损的重要风险因素。然而，2型糖尿病患者冠状动脉侧支减少的机制仍不清楚。本文结合近年来的研究，综述了2型糖尿病对冠状动脉侧支形成的致病作用，以及与慢性完全闭塞（CTO）2型糖尿病患者冠状动脉侧支形成减少相关的临床和生化指标。2型糖尿病患者的弥漫性冠状动脉粥样硬化降低了侧支供体动脉和侧支受体动脉之间的压力梯度，限制了侧支血管的生长和功能。晚期糖基化终产物与其受体之间的相互作用激活了几条细胞内信号通路，增强了氧化应激并加速了炎症过程。糖尿病状况降低促血管生成因子，特别是血管内皮生长因子和其他侧支血管生长相关参数。许多临床和生化因素可能会减弱冠状动脉侧支循环的发展已被报道。血清糖化白蛋白、胱抑素C和脂肪因子C1q肿瘤坏死因子相关蛋白1水平升高与2型糖尿病合并稳定性冠状动脉疾病和CTO患者冠状动脉侧支形成不良相关。主要侧支供血动脉的舒张压和狭窄程度也在冠状动脉侧支形成中起作用。T2DM通过涉及动脉生成和血管生成的多种机制损害侧支血管生长，T2DM和CTO患者的冠状动脉侧支形成受到各种临床、生化和血管造影因素的影响。这些信息为了解冠状动脉病理生理学和寻找T2DM潜在的新治疗靶点提供了见解。
The extent of coronary collateral formation is a primary determinant of the severity of myocardial damage and mortality after coronary artery occlusion. Type 2 diabetes mellitus (T2DM) represents an important risk factor for impaired collateral vessel growth. However, the mechanism of reduced coronary collateralization in type 2 diabetic patients remains unclear. With the reference to the recent researches, this review article describes the pathogenic effects of T2DM on collateral development and outlines possible clinical and biochemical markers associated with reduced coronary collateralization in type 2 diabetic patients with chronic total occlusion (CTO). Diffuse coronary atherosclerosis in T2DM reduces pressure gradient between collateral donor artery and collateral recipient one, limiting collateral vessel growth and function. An interaction between advanced glycation end-products and their receptor activates several intracellular signaling pathways, enhances oxidative stress and aggravates inflammatory process. Diabetic condition decreases pro-angiogenic factors especially vascular endothelial growth factor and other collateral vessel growth related parameters. Numerous clinical and biochemical factors that could possibly attenuate the development of coronary collaterals have been reported. Increased serum levels of glycated albumin, cystatin C, and adipokine C1q tumor necrosis factor related protein 1 were associated with poor coronary collateralization in type 2 diabetic patients with stable coronary artery disease and CTO. Diastolic blood pressure and stenosis severity of the predominant collateral donor artery also play a role in coronary collateral formation. T2DM impairs collateral vessel growth through multiple mechanisms involving arteriogenesis and angiogenesis, and coronary collateral formation in patients with T2DM and CTO is influenced by various clinical, biochemical and angiographic factors. This information provides insights into the understanding of coronary pathophysiology and searching for potential new therapeutic targets in T2DM.
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影响因子：
9.3
作者：
Biscetti F;Straface G;Arena V;Stigliano E;Pecorini G;Rizzo P;De Angelis G;Iuliano L;Ghirlanda G;Flex A
通讯作者：
Flex A
影响因子：
37.8
作者：
De Bruyne, B;Hersbach, F;Wijns, W
通讯作者：
Wijns, W
影响因子：
1.2
作者：
Borekci, A.;Gur, M.;Cayli, M.
通讯作者：
Cayli, M.
影响因子：
9.3
作者：
Kennedy MW;Fabris E;Suryapranata H;Kedhi E
通讯作者：
Kedhi E
DOI：
10.1111/j.1365-2362.2006.01641.x
发表时间：
2006-06-01
影响因子：
5.5
作者：
Gulec, S;Ozdemir, AO;Erol, C
通讯作者：
Erol, C