HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kyriakides, Z S Articles by Kremastinos, D T Search for Related Content PubMed PubMed Citation Articles by Kyriakides, Z S Articles by Kremastinos, D T

Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during angioplasty

Second Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece

Correspondence to:
Correspondence to:
Dr Zenon S Kyriakides, Onassis Cardiac Surgery Centre, 356 Syngrou Ave, 176 74 Athens, Greece;
zskyr{at}otenet.gr

Objective: To test whether type II diabetes prevents the recruitment of collaterals and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty.

Methods: Two groups of patients were studied. A collateral circulation group consisted of 56 patients, 18 diabetic and 38 non-diabetic. All underwent a minimum of three balloon inflations. A pressure guide wire was used for the measurement of coronary wedge pressure (mm Hg). The angioplasty protocol was repeated in another group of 57 patients (myocardial ischaemia group) using both surface and intracoronary ECGs to assess myocardial ischaemia.

Results: In diabetic patients, mean (SD) coronary wedge pressure was 35 (12) mm Hg during the first balloon inflation, 39 (15) mm Hg during the second (p < 0.05 v first inflation), and 42 (17) mm Hg during the third (p < 0.05 v first inflation); in non-diabetic patients the respective values were 36 (16), 37 (16), and 37 (16) mm Hg (F = 4.73, p = 0.01). The ratio of coronary wedge pressure to mean arterial pressure in diabetic patients in the three balloon inflations was 0.33 (0.11), 0.36 (0.13), and 0.39 (0.15), respectively (p < 0.05 v the first inflation); and in non-diabetic patients it was 0.33 (0.15), 0.34 (0.15), and 0.35 (0.15) (F = 1.92, p = 0.15). In the diabetic group the response was independent of the type of treatment. No difference between diabetic and non-diabetic patients was observed in the normal reduction of myocardial ischaemia on repeated balloon inflations.

Conclusions: Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty in single vessel disease, regardless of the type of antidiabetic treatment.

Keywords: collateral circulation; diabetes mellitus; angioplasty; myocardial ischaemia

Abbreviations: P_a, aortic pressure; P_W, coronary wedge pressure; Q_C, collateral flow; Q_N, maximum myocardial perfusion

This article has been cited by other articles:

				T. Kinnaird, E. Stabile, S. Zbinden, M.-S. Burnett, and S. E. Epstein Cardiovascular risk factors impair native collateral development and may impair efficacy of therapeutic interventions Cardiovasc Res, May 1, 2008; 78(2): 257 - 264. [Abstract] [Full Text] [PDF]

				Z. S. Kyriakides, I. Rassias, D. T. Kremastinos, D. Scheinert, R. Burckhard, S. Ropers, W.G. Daniel, J. Ludwig, V. Strnad, R. Sauer, et al. Intravascular {beta}-Radiation May Acutely Increase Coronary Collateral Blood Flow in Patients With Coronary Artery Disease * Response Circulation, January 28, 2003; 107 (3): e24 - e24. [Full Text] [PDF]