Noninvasive Imaging of Endothelial Damage in Patients with different HbA1c-levels, a Proof-of-Concept Study

TY - JOUR

T1 - Noninvasive Imaging of Endothelial Damage in Patients with different HbA1c-levels, a Proof-of-Concept Study

AU - Engel, Leif-Christopher

AU - Landmesser, Ulf

AU - Goehler, Alexander

AU - Gigengack, Kevin

AU - Wurster, Thomas

AU - Manes, Costantina

AU - Girke, Georg

AU - Jaguszewski, Milosz

AU - Skurk, Carsten

AU - Leistner, David M

AU - Lauten, Alexander

AU - Schuster, Andreas

AU - Noutsias, Michel

AU - Hamm, Bernd

AU - Botnar, Rene M

AU - Bigalke, Boris

AU - Makowski, Marcus R

N1 - © 2018 by the American Diabetes Association.

PY - 2018/11/28

Y1 - 2018/11/28

N2 - The aim of this study was to compare endothelial permeability, which is considered a hallmark of CAD, between patients with different HbA1c-levels using an albumin-binding-MR-probe. This cross-sectional-study included 26 patients with clinical indication for x-ray-angiography, which were classified into 3 groups according to their HbA1c-levels (HbA1c<5.7%,<39mmol/mol; HbA1c=5.7-6.4%,39-47mmol/mol; HbA1c≥6.5%,48mmol/mol). Subjects underwent gadofosveset-enhanced-coronary-magnetic-resonance and x-ray-angiography including optical-coherence-tomography (OCT) within 24hours. Contrast-to-noise-ratios 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 5.7-6.4% 0.30 increased normalized CNR values were measured, compared to 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 as compared to 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% as compared to patients with HbA1c-levels between 5.7-6.4% (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%); HbA1c<5.7%:n=10 (53%)).In conclusion, coronary-magnetic-resonance imaging in combination with an albumin-binding probe suggests that both patients with intermediate and high HbA1c-levels are associated with a higher extent of endothelial damage of the coronary arteries as compared to patients with HbA1c-levels below 5.7.

AB - The aim of this study was to compare endothelial permeability, which is considered a hallmark of CAD, between patients with different HbA1c-levels using an albumin-binding-MR-probe. This cross-sectional-study included 26 patients with clinical indication for x-ray-angiography, which were classified into 3 groups according to their HbA1c-levels (HbA1c<5.7%,<39mmol/mol; HbA1c=5.7-6.4%,39-47mmol/mol; HbA1c≥6.5%,48mmol/mol). Subjects underwent gadofosveset-enhanced-coronary-magnetic-resonance and x-ray-angiography including optical-coherence-tomography (OCT) within 24hours. Contrast-to-noise-ratios 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 5.7-6.4% 0.30 increased normalized CNR values were measured, compared to 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 as compared to 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% as compared to patients with HbA1c-levels between 5.7-6.4% (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%); HbA1c<5.7%:n=10 (53%)).In conclusion, coronary-magnetic-resonance imaging in combination with an albumin-binding probe suggests that both patients with intermediate and high HbA1c-levels are associated with a higher extent of endothelial damage of the coronary arteries as compared to patients with HbA1c-levels below 5.7.

U2 - 10.2337/db18-0239

DO - 10.2337/db18-0239

M3 - Article

C2 - 30487264

SN - 0012-1797

JO - Diabetes

JF - Diabetes

ER -