Impact of type 2 diabetes and the metabolic syndrome on myocardial structure and microvasculature of men with coronary artery disease.
Impact of type 2 diabetes and the metabolic syndrome on myocardial structure and microvasculature of men with coronary artery disease.
复制标题
DOI：
10.1186/1475-2840-10-80
复制
发表时间：
2011-09-19
影响因子：
9.3
通讯作者：
Kelly DJ
中科院分区：
文献类型：
--
作者：
Campbell DJ;Somaratne JB;Jenkins AJ;Prior DL;Yii M;Kenny JF;Newcomb AE;Schalkwijk CG;Black MJ;Kelly DJ
2型糖尿病和代谢综合征与舒张功能受损和心力衰竭风险增加有关。糖尿病心肌病的动物模型和尸检研究表明，心肌纤维化、心肌细胞肥大、心肌微血管结构改变和晚期糖基化终产物（AGEs）参与了糖尿病心肌病的发病机制。我们研究了2型糖尿病和代谢综合征是否与冠心病患者的心肌结构、微血管、AGEs和AGEs受体（AGEs）表达改变有关。我们对13例对照组、10例糖尿病患者和23例代谢综合征患者的左心室活检进行了组织学分析，这些患者接受了冠状动脉旁路移植术，没有心力衰竭或房颤，没有接受袢利尿剂治疗，也没有既往心肌梗死的证据。除了代谢参数的差异外，所有三组患者的冠状动脉疾病程度和临床特征相似。糖尿病和代谢综合征患者的肺毛细血管楔压高于对照组，糖尿病患者的二尖瓣间隔瓣环舒张期峰值速度（E '）降低，与舒张功能受损一致。糖尿病和代谢综合征患者均未出现心肌间质纤维化（苦天狼星红）增加，或I型和III型胶原、AGE Nε-（羧甲基）赖氨酸或β-内酰胺酶免疫染色增加。心肌细胞宽度、毛细血管长度密度、弥散半径和小动脉尺寸在三个患者组之间没有差异，而糖尿病和代谢综合征患者的血管周围纤维化减少。2型糖尿病和代谢综合征患者的舒张功能受损不依赖于心肌纤维化增加、心肌细胞肥大、心肌微血管结构改变或心肌Nε-（羧甲基）赖氨酸或Nε-（羧甲基）赖氨酸表达增加。这些结果表明，增加心肌纤维化和AGE表达，心肌细胞肥大，并改变微血管结构中描述的糖尿病性心脏病的后果，而不是一个起始原因，心功能不全。
Type 2 diabetes and the metabolic syndrome are associated with impaired diastolic function and increased heart failure risk. Animal models and autopsy studies of diabetic patients implicate myocardial fibrosis, cardiomyocyte hypertrophy, altered myocardial microvascular structure and advanced glycation end-products (AGEs) in the pathogenesis of diabetic cardiomyopathy. We investigated whether type 2 diabetes and the metabolic syndrome are associated with altered myocardial structure, microvasculature, and expression of AGEs and receptor for AGEs (RAGE) in men with coronary artery disease. We performed histological analysis of left ventricular biopsies from 13 control, 10 diabetic and 23 metabolic syndrome men undergoing coronary artery bypass graft surgery who did not have heart failure or atrial fibrillation, had not received loop diuretic therapy, and did not have evidence of previous myocardial infarction. All three patient groups had similar extent of coronary artery disease and clinical characteristics, apart from differences in metabolic parameters. Diabetic and metabolic syndrome patients had higher pulmonary capillary wedge pressure than controls, and diabetic patients had reduced mitral diastolic peak velocity of the septal mitral annulus (E'), consistent with impaired diastolic function. Neither diabetic nor metabolic syndrome patients had increased myocardial interstitial fibrosis (picrosirius red), or increased immunostaining for collagen I and III, the AGE Nε-(carboxymethyl)lysine, or RAGE. Cardiomyocyte width, capillary length density, diffusion radius, and arteriolar dimensions did not differ between the three patient groups, whereas diabetic and metabolic syndrome patients had reduced perivascular fibrosis. Impaired diastolic function of type 2 diabetic and metabolic syndrome patients was not dependent on increased myocardial fibrosis, cardiomyocyte hypertrophy, alteration of the myocardial microvascular structure, or increased myocardial expression of Nε-(carboxymethyl)lysine or RAGE. These findings suggest that the increased myocardial fibrosis and AGE expression, cardiomyocyte hypertrophy, and altered microvasculature structure described in diabetic heart disease were a consequence, rather than an initiating cause, of cardiac dysfunction.
登录
查看更多内容
影响因子：
24
作者：
Horwich, Tamara B.;Fonarow, Gregg C.
通讯作者：
Fonarow, Gregg C.
影响因子：
7.7
作者：
Ilercil, A;Devereux, RB;Howard, BV
通讯作者：
Howard, BV
DOI：
10.1196/annals.1333.074
发表时间：
2005-01-01
期刊：
MAILLARD REACTION: CHEMISTRY AT THE INTERFACE OF NUTRITION, AGING, AND DISEASE
影响因子：
--
作者：
Januszewski, AS;Thomas, MC;Jenkins, AJ
通讯作者：
Jenkins, AJ
影响因子：
4.8
作者：
FACTOR, SM;MINASE, T;SONNENBLICK, EH
通讯作者：
SONNENBLICK, EH
影响因子：
24
作者：
Page, Anik;Dumesnil, Jean G.;Pibarot, Philippe
通讯作者：
Pibarot, Philippe