Myocardial flow reserve assessed by cardiac 82Rb positron emission tomography/computed tomography is associated with albumin excretion in patients with Type 1 diabetes
Myocardial flow reserve assessed by cardiac 82Rb positron emission tomography/computed tomography is associated with albumin excretion in patients with Type 1 diabetes
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通过心脏 82Rb 正电子发射断层扫描/计算机断层扫描评估的心肌血流储备与 1 型糖尿病患者的白蛋白排泄相关
DOI：
10.1093/ehjci/jey174
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
T. Hansen
中科院分区：
文献类型：
--
作者：
E. Zobel;S. Winther;P. Hasbak;B. V. von Scholten;L. Holmvang;A. Kjaer;P. Rossing;T. Hansen
摘要目的评价1型糖尿病伴或不伴蛋白尿患者和非糖尿病对照者的心肌血流储备（MFR）和冠状动脉钙化（CAC）。MFR反映心外膜大动脉和心肌微循环的功能。CAC代表动脉粥样硬化的结构方面。此外，我们评估了MFR和CAC与视网膜病变（另一种微血管并发症）的关系。方法和结果横断面研究1型糖尿病，分层正常白蛋白尿（NORMO; n = 30）和大量白蛋白尿（MACRO; n = 30），并在非糖尿病对照组（n = 30）。通过心脏82 Rb正电子发射断层扫描/计算机断层扫描评价MFR（药理学应力流/静息流）。NORMO患者和对照组的MFR相似（3.1 ± 0.79 vs. 3.0 ± 0.79; P = 0.74）。与NORMO相比，MACRO患者的MFR较低（受损）（2.1 ± 0.92 vs. 3.1 ± 0.79; P < 0.0001）。与对照组相比，NORMO组的CAC评分[中位数（四分位距）]较高[72（22-247）vs. 0（0-81），P = 0.03]，并且MACRO和NORMO之间具有可比性。糖尿病合并单纯性视网膜病变或无视网膜病变患者的MFR相当（n = 24和n = 12，2.8 ± 0.84 vs. 3.3 ± 0.77，P = 0.11），但增殖性视网膜病变患者（n = 24）的MFR低于单纯性视网膜病变患者（2.1 ± 0.97 vs. 2.8 ± 0.84，P = 0.02）。视网膜病变组之间的CAC评分相当。结论非糖尿病对照组和1型糖尿病伴NORMO患者的心肌微血管功能相当;但在存在微血管并发症（MACRO和增殖性视网膜病变）时受损。然而，糖尿病患者冠状动脉钙化升高，不能用蛋白尿解释。
Abstract Aims To evaluate myocardial flow reserve (MFR) and coronary artery calcium (CAC) in persons with Type 1 diabetes with or without albuminuria and in non-diabetic controls. MFR reflects the function of large epicardial arteries and myocardial microcirculation. CAC represents structural aspects of atherosclerosis. In addition, we evaluated the association of MFR and CAC with retinopathy, another microvascular complication. Methods and results Cross-sectional study in Type 1 diabetes, stratified by normoalbuminuria (NORMO; n = 30) and macroalbuminuria (MACRO; n = 30), and in non-diabetic controls (n = 30). MFR (pharmacological stress flow/rest flow) was evaluated by cardiac 82Rb positron emission tomography/computed tomography. MFR was similar in patients with NORMO and controls (3.1 ± 0.79 vs. 3.0 ± 0.79; P = 0.74). Patients with MACRO had lower (impaired) MFR when compared with NORMO (2.1 ± 0.92 vs. 3.1 ± 0.79; P < 0.0001). The CAC score [median (interquartile range)] was higher in NORMO when compared with controls [72 (22–247) vs. 0 (0–81), P = 0.03], and comparable between MACRO and NORMO. MFR was comparable in patients with diabetes and simplex or no retinopathy (n = 24 and n = 12, 2.8 ± 0.84 vs. 3.3 ± 0.77, P = 0.11), but lower in proliferative (n = 24) compared with simplex retinopathy (2.1 ± 0.97 vs. 2.8 ± 0.84, P = 0.02). The CAC score was comparable between groups of retinopathy. Conclusion Myocardial microvascular function was comparable in non-diabetic controls and patients with Type 1 diabetes and NORMO; but impaired in the presence of microvascular complications (MACRO and proliferative retinopathy). Coronary calcification was elevated in diabetes, however, not explained by albuminuria.
影响因子：
158.5
作者：
Detrano, Robert;Guerci, Alan D.;Kronmal, Richard A.
通讯作者：
Kronmal, Richard A.
影响因子：
14
作者：
Schindler, Thomas H.;Schelbert, Heinrich R.;Dilsizian, Vasken
通讯作者：
Dilsizian, Vasken