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Title:

Noninvasive Imaging of Endothelial Damage in Patients With Different HbA1c Levels: A Proof-of-Concept Study.

Document type:
Article; Journal Article; Research Support, Non-U.S. Gov't
Author(s):
Engel, Leif-Christopher; Landmesser, Ulf; Goehler, Alexander; Gigengack, Kevin; Wurster, Thomas-Heinrich; Manes, Costantina; Girke, Georg; Jaguszewski, Milosz; Skurk, Carsten; Leistner, David M; Lauten, Alexander; Schuster, Andreas; Noutsias, Michel; Hamm, Bernd; Botnar, Rene M; Bigalke, Boris; Makowski, Marcus R
Abstract:
The aim of this study was to compare endothelial permeability, which is considered a hallmark of coronary artery disease, between patients with different HbA1c levels using an albumin-binding magnetic resonance (MR) probe. This cross-sectional study included 26 patients with clinical indication for X-ray angiography who were classified into three groups according to HbA1c level (<5.7% [<39 mmol/mol], 5.7-6.4% [39-47 mmol/mol], and ≥6.5% [48 mmol/mol]). Subjects underwent gadofosveset-enhanced coronary magnetic resonance and X-ray angiography including optical coherence within 24 h. Contrast-to-noise ratios (CNRs) were assessed to measure the probe uptake in the coronary wall by coronary segment, excluding those with culprit lesions in X-ray angiography. In the group of patients with HbA1c levels between 5.7 and 6.4%, 0.30 increased normalized CNR values were measured, compared with patients with HbA1c levels <5.7% (0.30 [95% CI 0.04, 0.57]). In patients with HbA1c levels ≥6.5%, we found 0.57 higher normalized CNR values compared with patients with normal HbA1c levels (0.57 [95% CI 0.28, 0.85]) and 0.26 higher CNR values for patients with HbA1c level ≥6.5% compared with patients with HbA1c levels between 5.7 and 6.4% (0.26 [95% CI -0.04, 0.57]). Additionally, late atherosclerotic lesions were more common in patients with high HbA1c levels (HbA1c ≥6.5%, n = 14 [74%]; HbA1c 5.7-6.4%, n = 6 [60%]; and HbA1c <5.7%, n = 10 [53%]). In conclusion, coronary MRI in combination with an albumin-binding MR probe suggests that both patients with intermediate and patients with high HbA1c levels are associated with a higher extent of endothelial damage of the coronary arteries compared with patients with HbA1c levels <5.7%.
Journal title abbreviation:
Diabetes
Year:
2019
Journal volume:
68
Journal issue:
2
Pages contribution:
387-394
Fulltext / DOI:
doi:10.2337/db18-0239
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/30487264
Print-ISSN:
0012-1797
TUM Institution:
Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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