Title
Endothelial function and baroreflex sensitivity according to the oral glucose tolerance test in patients with coronary artery disease and normal fasting glucose levels
Author
Wykretowicz, A.
Guzik, P.
Bartkowiak, G.
Krauze, T.
Kasinowski, R.
Dziarmaga, M.
Wesseling, K.H.
Wysocki, H.
TNO Biomedical Instrumentation
Publication year
2005
Abstract
Endothelial dysfunction and reduced BRS (baroreflex sensitivity) may be present in patients with CAD (coronary artery disease). The normal fasting glucose level does not exclude abnormal glucose metabolism in patients with CAD. The aim of present study was to evaluate endothelial function and BRS according to glucose metabolism in patients with normal fasting plasma glucose and stable CAD subjected to PTCA (percutaneous transluminal coronary angioplasty). Forty-six consecutive patients who underwent elective PTCA were studied (37 men; mean age 56 years). Endothelial function was assessed non-invasively using the arterial vasodilator response to salbutamol (albuterol). BRS was measured using a cross-correlation method. The extent of coronary narrowing was estimated by calculation of the Gensini score. All patients underwent a 75 g OGTT (oral glucose tolerance test). IGT (impaired glucose tolerance) or diabetes was present in approx. 60% of patients. The vasodilator response to salbutamol, as a measure of endothelial dysfunction, was significantly impaired in patients with IGT or diabetes compared with those with normal glucose tolerance (- 0.5 ± 1.6% compared with - 7.9 ± 2.2; P = 0.01). Glucose metabolism and age were significant predictors of endothelial dysfunction (R2 = 35.2%, P = 0.02). BRS did not differ significantly between patients with normal glucose tolerance and those with IGT or diabetes (6.9 ± 1.2 compared with 6.1 ± 0.6 ms/mmHg respectively; P = 0.669). BRS was negatively correlated with age (r= -0.34, P = 0.021) and the Gensini score (r= -0.34, P = 0.022). The significant predictors of BRS were Gensini score, age and past myocardial infarction (R2 = 37.02%, P = 0.002). Patients with established CAD, normal fasting glucose and IGT or diabetes demonstrated impaired endothelial function which did not correlate with the extent of coronary artery involvement. Conversely, BRS in the study population was not affected by glucose metabolism, but showed an interaction with the extent of coronary narrowing. © 2005 The Biochemical Society. Chemicals / CAS: salbutamol, 18559-94-9; Albuterol, 18559-94-9; Blood Glucose; Vasodilator Agents
Subject
Augmentation index
Baroreflex sensitivity
Coronary artery disease
Diabetes
Endothelial function
Glucose tolerance
salbutamol
age
clinical article
controlled study
coronary artery disease
coronary hemodynamics
diabetes mellitus
endothelium
glucose blood level
glucose metabolism
heart infarction
impaired glucose tolerance
oral glucose tolerance test
pressoreceptor reflex
priority journal
scoring system
transluminal coronary angioplasty
Adult
Aged
Aging
Albuterol
Angioplasty, Transluminal, Percutaneous Coronary
Baroreflex
Blood Glucose
Coronary Arteriosclerosis
Diabetes Mellitus
Endothelium, Vascular
Fasting
Female
Glucose Tolerance Test
Hemodynamic Processes
Humans
Male
Middle Aged
Severity of Illness Index
Vasodilator Agents
To reference this document use:
http://resolver.tudelft.nl/uuid:a8e3ca25-fa1d-4d6f-9494-5279a4687935
DOI
https://doi.org/10.1042/cs20050095
TNO identifier
238728
ISSN
0143-5221
Source
Clinical Science, 109 (4), 397-403
Document type
article