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Coronary Endothelial Dysfunction in Women With Type 2 Diabetes Measured by Coronary Phase Contrast Flow Velocity Magnetic Resonance Imaging
  1. Christopher D. Maroules, MD*,
  2. Alice Y. Chang, MD, MSc,
  3. Melanie S. Kotys-Traughber, PhD,
  4. Ronald M. Peshock, MD*,§
  1. From the *Cardiothoracic Imaging Division, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX; †Division of Endocrinology, Metabolism, Diabetes and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN; ‡MR Clinical Science, Philips Healthcare, Cleveland, OH; and §Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
  1. Received March 23, 2015, and in revised form May 23, 2015.
  2. Accepted for publication May 30, 2015.
  3. Reprints: Christopher D. Maroules, MD, Cardiothoracic Imaging Division, Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390. E-mail: Christopher.Maroules{at}phhs.org.
  4. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award no. UL1TR001105. A.Y.C. was supported by an AHA Fellow to Faculty award and the Office of Women’s Health Research (Building Interdisciplinary Careers in Women’s Health award K12HD065987).
  5. The authors have no conflicts of interest to declare.

Abstract

Objective The aim of this study was to determine if differences in coronary endothelial function are observed between asymptomatic women with type 2 diabetes mellitus (DM) and control subjects using coronary phase contrast flow velocity magnetic resonance imaging in response to cold pressor stress, an established endothelium-dependent vasodilatory stress.

Methods Phase contrast flow velocity imaging of the right coronary artery was performed in 7 asymptomatic premenopausal women with DM and 8 healthy female participants in response to the cold pressor test at 3 T.

Results There was no significant difference in percent increase in coronary flow velocity from rest to peak flow velocity between DM and control subjects (32% ± 22% vs 46% ± 17%; P = 0.11). However, percent increase in coronary flow velocity was lower in DM than in control subjects (−3% ± 14% vs 31% ± 30%; P = 0.01) during the second minute of cold pressor stress, when endothelial-mediated vasodilation should occur.

Conclusions Asymptomatic women with DM demonstrate reduced coronary flow velocity during the second minute of cold pressor stress, indicating coronary endothelial dysfunction.

Key Words
  • cardiac magnetic resonance
  • coronary blood flow reserve
  • coronary flow
  • endothelial dysfunction

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