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Abstract: FR-PO429

Myocardial Flow Reserve Assessed by Cardiac 82Rb PET/CT Is Associated with Albumin Excretion in Patients with Type 1 Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Hein Zobel, Emilie, Steno Diabetes Center, Gentofte, Denmark
  • Winther, Signe Abitz, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Von Scholten, Bernt Johan, Novo Nordisk A/S, Soborg, Denmark
  • Holmvang, Lene, Rigshopitalet , Copenhagen Ø, Denmark
  • Kjaer, Andreas, Rigshospitalet, Copenhagen, Denmark
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Hansen, Tine, Steno Diabetes Center, Gentofte, Denmark
Background

To evaluate myocardial flow reserve (MFR) and coronary artery calcium (CAC) in persons with type 1 diabetes with or without albuminuria and in non-diabetic controls. MFR reflects the function of large epicardial arteries and myocardial microcirculation. CAC represents structural aspects of atherosclerosis. In addition we evaluated the association of MFR and CAC with retinopathy, another microvascular complication

Methods

Cross-sectional study in type 1 diabetes, stratified by normoalbuminuria (n=30) and macroalbuminuria (n=30), and in non-diabetic controls (n=30). MFR (pharmacological stress flow/rest flow) was evaluated by cardiac 82Rb positron emission tomography/computed tomography.

Results

MFR was similar in patients with normomalbuminuria (NORMO) and controls (3.1 ± 0.8 vs. 3.0 ± 0.79; p=0.74). Patients with macroalbuminuria (MACRO) had lower (impaired) MFR compared to NORMO (2.1 ± 0.9 vs. 3.1 ± 0.8; p < 0.0001). The CAC score (median[IQR]) was higher in NORMO compared to controls (72[22-247] vs. 0[0-81], p=0.018), and comparable between MACRO and NORMO. MFR was comparable in patients with diabetes and simplex or no retinopathy (n=24 and n=12, 2.8 ± 0.84 vs. 3.3 ± 0.77, p=0.11), but lower in proliferative (n=24) compared to simplex retinopathy (2.1 ± 0.97 vs. 2.8 ± 0.84, p=0.02). The CAC score was comparable between groups of retinopathy.

Conclusion

Myocardial microvascular function was comparable in non-diabetic controls and patients with type 1 diabetes and normoalbuminuria; but impaired in the presence of microvascular complications (macroalbuminuria and proliferative retinopathy). Coronary calcification was elevated in diabetes, however not explained by albuminuria.