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67 THE RENIN-ANGIOTENSIN SYSTEM IN CARDIOVASCULAR DISEASE IN DIABETICS
  1. P. I. Altieri1,
  2. H. Banch1,
  3. N. Escobales1,
  4. M. J. Crespo1
  1. 1University of Puerto Rico, Medical Sciences Campus

Abstract

Nine diabetic patients with coronary disease were catheterized to obtain samples of coronary sinus and of aorta, in which the levels of ET-1 and Ang II were determined using radioimmunoassay. The diameters of the right coronary artery (RCA) and anterior descending coronary artery (CAD) were determined by image analysis. The results were compared with the ones obtained in 13 normal patients who were studied using similar procedures. In the diabetic patients, the levels of Ang II in the coronary sinus and in the aorta were 46 ± 18 pg/mL and 35 ± 15 pg/mL, respectively. These values were greater (4-fold) than those in the coronary and peripheral circulation of the normal patients (10 ± 3 pg /mL, p < .05). Similarly, the levels of E-1 in the coronary sinus were evaluated and compared with standard values (coronary breast: 14 ± 6 pg/mL and aorta: 13 ± 3 pg/mL, normal: 3 ± 1 pg/mL, respectively; p < .05). It was also observed that the diameter of the RCA in diabetics was of smaller size than that of normal people (3.01 ± 0.88 versus 3.909 ± 1.0 mm, respectively, p < .05). The descending anterior coronary artery (CAD) of diabetic patients also showed a diameter smaller to that of the control (3.43 ± 0.79 versus 4.61 ± 1.0 mm, p < .05). A negative correlation among the levels of the peptides and the coronary diameters was observed with an r = .51 (p < .05). The levels of Ang -II and ET-1 in the coronary sinus and in the aorta were elevated in diabetic patients when compared with controls. The diameters of the RCA and CAD in diabetic patients were decreased when compared with those of the control and correlated with the levels of the peptides in the coronary circulation. These findings suggest that the angiopathy in diabetic patients could be related to structural alterations of the vasculature induced by the high levels of angiotensin II and endothelin I.

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