Relationship between HgbA1c and myocardial blood flow reserve in patients with type 2 diabetes mellitus: Noninvasive assessment using real-time myocardial perfusion echocardiography

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. © 2014 runqing huang,et al.