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Journal of Diabetes Research
Volume 2014 (2014), Article ID 243518, 8 pages
http://dx.doi.org/10.1155/2014/243518
Clinical Study

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

1Mayo Clinic Cardiovascular Ultrasound and Hemodynamic Laboratory, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
2Division of Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
3Division of Cardiovascular Medicine, Assiut University, Assiut 71515, Egypt

Received 28 April 2014; Accepted 9 June 2014; Published 2 July 2014

Academic Editor: Nikolaos Papanas

Copyright © 2014 Runqing Huang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 and MBFR than those with HgbA1c ≤ 7.1% . In patients with suspected CAD, there was a significant inverse correlation between MBFR and HgbA1c ( , ); however, in those with known CAD, this relationship was not significant ( , ). 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, ). Optimal glycemic control is associated with preservation of MBFR as determined by RTMPE, in T2DM patients at risk for CAD.