Relationship between HgbA1c and Myocardial Blood Flow Reserve in Patients with Type 2 Diabetes Mellitus: Noninvasive Assessment Using Real-Time Myocardial Perfusion Echocardiography

الملخص EN

To study the relationship between glycosylated hemoglobin (HgbA1c) and myocardial perfusion in type 2 diabetes mellitus (T2DM) patients, we prospectively enrolled 24 patients with known or suspected coronary artery disease (CAD) who underwent adenosine stress by real-time myocardial perfusion echocardiography (RTMPE).

HgbA1c was measured at time of RTMPE.

Microbubble velocity (β min−1), myocardial blood flow (MBF, mL/min/g), and myocardial blood flow reserve (MBFR) were quantified.

Quantitative MCE analysis was feasible in all patients (272/384 segments, 71%).

Those with HgbA1c > 7.1% had significantly lower β reserve and MBFR than those with HgbA1c ≤ 7.1% ( P < 0.05 ) .

In patients with suspected CAD, there was a significant inverse correlation between MBFR and HgbA1c ( r = - 0.279 , P = 0.01 ); however, in those with known CAD, this relationship was not significant ( r = - 0.117 , P = 0.129 ).

Using a MBFR cutoff value > 2 as normal, HgbA1c > 7.1% significantly increased the risk for abnormal MBFR, (adjusted odds ratio: 1.92, 95% CI: 1.12–3.35, P = 0.02 ).

Optimal glycemic control is associated with preservation of MBFR as determined by RTMPE, in T2DM patients at risk for CAD.