Noninvasive imaging of endothelial damage in patients with different HbA1clevels: A proof-of-concept study

Engel LC, Landmesser U, Goehler A, Gigengack K, Wurster TH, Manes C, Girke G, Jaguszewski M, Skurk C, Leistner DM, Lauten A, Schuster A, Noutsias M, Hamm B, Botnar RM, Bigalke B, Makowski MR (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Diabetes American Diabetes Association

Book Volume: 68

Pages Range: 387-394

Journal Issue: 2

DOI: 10.2337/db18-0239

Abstract

The aim of this study was to compare endothelial permeability, which is considered a hallmark of coronary artery disease, between patients with different HbA 1c 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 HbA 1c 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 HbA 1c levels between 5.7 and 6.4%, 0.30 increased normalized CNR values were measured, compared with patients with HbA 1c levels <5.7% (0.30 [95% CI 0.04, 0.57]). In patients with HbA 1c levels ≥6.5%, we found 0.57 higher normalized CNR values compared with patients with normal HbA 1c levels (0.57 [95% CI 0.28, 0.85]) and 0.26 higher CNR values for patients with HbA 1c level ≥6.5% compared with patients with HbA 1c levels between 5.7 and 6.4% (0.26 [95% CI 20.04, 0.57]). Additionally, late atherosclerotic lesions were more common in patients with high HbA 1c levels (HbA 1c ≥6.5%, n = 14 [74%]; HbA 1c 5.7–6.4%, n = 6 [60%]; and HbA 1c <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 HbA 1c levels are associated with a higher extent of endothelial damage of the coronary arteries compared with patients with HbA 1c levels <5.7%.

Involved external institutions

Charité - Universitätsmedizin Berlin DE Germany (DE) Brigham and Women's Hospital (BWH) US United States (USA) (US) Georg-August-Universität Göttingen DE Germany (DE) Martin-Luther-Universität Halle-Wittenberg (MLU) DE Germany (DE) Pontificia Universidad Católica de Chile CL Chile (CL)

How to cite

APA:

Engel, L.-C., Landmesser, U., Goehler, A., Gigengack, K., Wurster, T.-H., Manes, C.,... Makowski, M.R. (2019). Noninvasive imaging of endothelial damage in patients with different HbA1clevels: A proof-of-concept study. Diabetes, 68(2), 387-394. https://doi.org/10.2337/db18-0239

MLA:

Engel, Leif-Christopher, et al. "Noninvasive imaging of endothelial damage in patients with different HbA1clevels: A proof-of-concept study." Diabetes 68.2 (2019): 387-394.

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