Microvascular dysfunction in patients with diabetes mellitus: assessment of absolute coronary flow and microvascular resistance reserve

Abstract Background Coronary microvascular dysfunction (CMD) is an early feature of diabetic cardiomyopathy, which usually precedes the onset systolic and diastolic (DDF). Continuous intracoronary thermodilution allows accurate reproducible assessment absolute coronary blood flow resistance thus allowing evaluation reserve (CFR) Microvascular Resistance Reserve (MRR), a novel index specific for function, independent from myocardial mass. In present study we compared resistance, CFR MRR assessed by continuous in versus non-diabetic patients. Left atrial reservoir strain (LASr), marker DDF was between two groups. Methods this observational retrospective study, 108 patients with suspected angina non-obstructive artery disease (NOCAD) consecutively undergoing elective angiography (CAG) September 2018 to June 2021 were enrolled. The invasive functional function performed left anterior descending (LAD) thermodilution. Patients classified according presence DM. Absolute resting hyperemic (in mL/min) WU) cohorts. FFR measured assess epicardial lesions, while calculated function. LAS, speckle tracking echocardiography, used detect structural changes potentially associated dysfunction. Results median value 0.83 [0.79–0.87] without any significant difference similar Similarly, resistances did not change significantly DM cohort lower control group (CFR=2.4±0.6 2.9±0.8; MRR=2.8±0.9 3.5±1 respectively, [p<0.05 both], Figure 1 2). Likewise, had reservoir, contractile conductive LAS (all p<0.05). Conclusions Compared patients, arteries, both similar. LASr confirming subclinical microcirculatory impairment. thermodilution-derived indexes provide reliable operator-independent macro- microvasculature might facilitate widespread clinical adoption physiologic disease. Funding Acknowledgement Type funding sources: None.