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

Research output: Contribution to journalArticle

Leif-Christopher Engel, Ulf Landmesser, Alexander Goehler, Kevin Gigengack, Thomas Wurster, Costantina Manes, Georg Girke, Milosz Jaguszewski, Carsten Skurk, David M Leistner, Alexander Lauten, Andreas Schuster, Michel Noutsias, Bernd Hamm, Rene M Botnar, Boris Bigalke, Marcus R Makowski

Original languageEnglish
JournalDiabetes
Early online date28 Nov 2018
DOIs
Publication statusE-pub ahead of print - 28 Nov 2018

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Abstract

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.

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