Prognostic Meaning of Coronary Flow Reserve in Type 2 Diabetes Mellitus: A Transoesophageal Doppler Echo cardiographic Study

Background: Vasodilator stress echocardiography allows dual imaging of regional wall motion and Coronary Flow Reserve (CFR) on Left Anterior Descending (LAD) artery.Diabetes may affect CFR independently of obstructive Coronary Artery Disease (CAD) through coronary microcirculatory damage.Aim of the Work: The authors sought to determine coronary flow reserve in diabetic patients versus non diabetics in patients with LAD stenosis ≥50% with Doppler-TEE.Methods: 30 patients with Proximal LAD stenosis ≥50%, CFR was determined by dipyridamole stress transesophageal echo.Exclusion criteria: Any acute MI, end stage malignancy, previous CABG patients, any contraindications for coronary angiography, dipyridamole or TEE.Results: The mean CFR was 1.9±0.3 in non-diabetics and 1.7±0.4 in diabetics, univariate regression showed significant impact of diabetes on CRF where diabetes decreases CRF by 0.25, (p 0.044). However, multivariate regression explored no impact of diabetes, hypertension, dyslipidemia, age, beta blockade, and statins use upon CRF but, beta blockade was found to have a significant impact upon CRF (OR: 0.608, CI 95%: 0.443-0.772, p value 0.001).Conclusion: CFR on LAD provides useful information for vessel stenosis in both diabetics and non diabetic patients.