Turk Kardiyol Dern Ars. 2015; 43(1): 49-57 | DOI: 10.5543/tkda.2015.59432
Left ventricle geometry affects coronary flow reserve in diabetic patients
Gülhan Yüksel Kalkan1
, Mustafa Gur2
, Zafer Elbasan1
, Ahmet Oytun Baykan1
, Osman Kuloğlu1
, Durmuş Yıldıray Şahin1
, Taner Şeker1
, Filiz Ekşi Haydardedeoğlu3
, Ömer Şen1
, Hakan Uçar1
, Sinan Kırım4
, Murat Çaylı11
Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey2
Department of Cardiology, Kafkas University Faculty of Medicine, Kars, Turkey3
Department of Cardiology, Baskent University Faculty of Medicine, Adana Hospital, Adana, Turkey4
Department of Endocrinology, Adana Numune Training and Research Hospital, Adana, Turkey
OBJECTIVES The aim of this study was to investigate the association between coronary flow reserve (CFR) and left ventricle (LV) geometric patterns in patients with newly-diagnosed diabetes mellitus (DM).
STUDY DESIGN We studied 116 patients with newly-diagnosed DM and 31 healthy control subjects. Echocardiographic examination was performed on all subjects. Four different geometric patterns were identified in diabetic patients, according to LV mass index (LVMI) and relative wall thickness (RWT) [NG: Normal geometry; CR: Concentric remodeling; EH: Eccentric hypertrophy; CH: Concentric hypertrophy]. CFR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio.
RESULTS Compared with controls, CFR was decreased in diabetic patients (p<0.05). The lowest CFR values were observed in the CH group compared with control and other groups (p<0.05, for all). Also, CFR values of the CR and EH groups were lower than NG and the control group (p<0.05, for all). CFR was associated with LV geometry (r=-0.449, p=0.001), LVMI (r=-0.401, p<0.001), RWT (r=-0.247, p=0.008), HbA1c (r=-0.576, p<0.001) and mitral valve E/A ratio (r=0.239, p=0.01) in bivariate analysis. CFR was independently associated with LV geometry (β=-0.449, p<0.001), LVMI (β=-0.192, p=0.016), and HbA1c (β=-0.576, p<0.001) in multivariate analysis.
CONCLUSION CFR was impaired in newly-diagnosed DM. The degree of this deformation increases from normal geometry towards to concentric hypertrophy. This condition suggests that myocardial structural remodeling due to diabetes might be effective on CFR.
Blood flow velocity, coronary circulation, diabetes mellitus; echocardiography; hypertrophy, left ventricular
How to cite this article
Gülhan Yüksel Kalkan, Mustafa Gur, Zafer Elbasan, Ahmet Oytun Baykan, Osman Kuloğlu, Durmuş Yıldıray Şahin, Taner Şeker, Filiz Ekşi Haydardedeoğlu, Ömer Şen, Hakan Uçar, Sinan Kırım, Murat Çaylı. Left ventricle geometry affects coronary flow reserve in diabetic patients. Turk Kardiyol Dern Ars. 2015; 43(1): 49-57
Corresponding Author: Gülhan Yüksel Kalkan, Türkiye