Diabetes and haemodynamic reactions to acute coronary occlusion
Background: The risk of early sudden death before hospital admission is higher in diabetic than non-diabetic men with acute myocardial infarction and autonomic nervous activity may modify the clinical outcome of abrupt coronary occlusion. Since diabetes mellitus may interfere with autonomic and myoc...
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| Veröffentlicht in: | International journal of cardiology 2004-06, Vol.95 (2), p.237-244 |
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| container_title | International journal of cardiology |
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| creator | Airaksinen, K.E.Juhani Koivikko, Minna L. Niemelä, Matti J. Tahvanainen, Kari U.O. Linnaluoto, Markku Huikuri, Heikki V. |
| description | Background: The risk of early sudden death before hospital admission is higher in diabetic than non-diabetic men with acute myocardial infarction and autonomic nervous activity may modify the clinical outcome of abrupt coronary occlusion. Since diabetes mellitus may interfere with autonomic and myocardial function, we decided to study whether diabetes alters autonomic and haemodynamic responses to acute coronary occlusion.
Methods: We analyzed the changes in heart rate, heart rate variability and blood pressure, and the occurrence of ventricular ectopy during a 2-min coronary occlusion in 238 non-diabetic and 32 diabetic patients referred for single vessel coronary angioplasty. The ranges of non-specific responses were determined by analyzing a control group of 19 patients with no ischaemia during a 2-min balloon inflation in a totally occluded coronary artery.
Results: Diabetic patients were more often (
p |
| doi_str_mv | 10.1016/j.ijcard.2003.06.004 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72025526</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0167527303004121</els_id><sourcerecordid>72025526</sourcerecordid><originalsourceid>FETCH-LOGICAL-c388t-a2233d604ea16ec53f43da4d2108120a85760243c6def5121130265f469ffb3b3</originalsourceid><addsrcrecordid>eNp9kE1r3DAURUVISaaT_INQvGl3dvVtzyYhJE1aCHTTrsWbp2eiwbZSyS7Mv6_CDKSrrN7inXu5HMauBG8EF_brrgk7hOQbyblquG041ydsJbpW16I1-pStCtbWRrbqnH3MeccLsdl0Z-xcGLFRnbQrdnMfYEsz5QomXz0DjdHvJxgDVokA5xCnXM2xAlxmqjCmOEHaVxFxWHJ5XrAPPQyZLo93zX4_fPt1971--vn44-72qUbVdXMNUirlLdcEwhIa1WvlQXspeCckh860lkut0HrqjZBCKC6t6bXd9P1WbdWafTn0vqT4Z6E8uzFkpGGAieKSXSu5NEbaAuoDiCnmnKh3LymMZbMT3L2Kczt3EOdexTluXdFSYp-O_ct2JP8WOpoqwOcjABlh6BNMGPJ_XCeMLrPX7PrAUbHxN1ByGQNNSD4kwtn5GN5f8g-XlYx1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72025526</pqid></control><display><type>article</type><title>Diabetes and haemodynamic reactions to acute coronary occlusion</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Airaksinen, K.E.Juhani ; Koivikko, Minna L. ; Niemelä, Matti J. ; Tahvanainen, Kari U.O. ; Linnaluoto, Markku ; Huikuri, Heikki V.</creator><creatorcontrib>Airaksinen, K.E.Juhani ; Koivikko, Minna L. ; Niemelä, Matti J. ; Tahvanainen, Kari U.O. ; Linnaluoto, Markku ; Huikuri, Heikki V.</creatorcontrib><description>Background: The risk of early sudden death before hospital admission is higher in diabetic than non-diabetic men with acute myocardial infarction and autonomic nervous activity may modify the clinical outcome of abrupt coronary occlusion. Since diabetes mellitus may interfere with autonomic and myocardial function, we decided to study whether diabetes alters autonomic and haemodynamic responses to acute coronary occlusion.
Methods: We analyzed the changes in heart rate, heart rate variability and blood pressure, and the occurrence of ventricular ectopy during a 2-min coronary occlusion in 238 non-diabetic and 32 diabetic patients referred for single vessel coronary angioplasty. The ranges of non-specific responses were determined by analyzing a control group of 19 patients with no ischaemia during a 2-min balloon inflation in a totally occluded coronary artery.
Results: Diabetic patients were more often (
p<0.05) female, but there were no significant differences in the occluded vessel or incidence of ST changes or chest pain during coronary occlusion between the groups. Incidence of significant heart rate reactions and ventricular arrhythmias was comparable in both groups. Systolic blood pressure decreased (
p=0.01) in the diabetic patients during coronary occlusion, but did not change significantly in the non-diabetic group. Coronary occlusion caused more often (34% vs. 14%,
p<0.01) a significant decrease in blood pressure in diabetic patients
. Logistic regression models developed to analyze the significance of diabetes while controlling for baseline variables and signs of ischaemia identified diabetes to be an independent predictor of hypotensive reactions (odds ratio [OR] 2.9, 95% confidence intervals 1.1–7.8,
p<0.05), while female gender and high short-term heart rate variability were other independent predictors of hypotensive reactions.
Conclusions: Diabetic patients often develop significant hypotension during the early phase of acute coronary occlusion. This abnormality may be related to diabetic cardiomyopathy and impairment of baroreflex-mediated regulation of circulation. Predisposition to hypotension may contribute to the observed differences in the clinical presentation and outcome of acute coronary events.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2003.06.004</identifier><identifier>PMID: 15193826</identifier><identifier>CODEN: IJCDD5</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Autonomic Nervous System - physiopathology ; Autonomic Nervous System Diseases - etiology ; Autonomic Nervous System Diseases - physiopathology ; Autonomic neuropathy ; Baroreflex ; Baroreflexes ; Biological and medical sciences ; Blood pressure ; Cardiology. Vascular system ; Case-Control Studies ; Coronary Disease - complications ; Coronary Disease - physiopathology ; Coronary heart disease ; Diabetes Complications ; Female ; Heart ; Heart rate ; Hemodynamics ; Humans ; Hypotension - etiology ; Hypotension - physiopathology ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Ventricular Premature Complexes - etiology ; Ventricular Premature Complexes - physiopathology</subject><ispartof>International journal of cardiology, 2004-06, Vol.95 (2), p.237-244</ispartof><rights>2003 Elsevier Ireland Ltd</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c388t-a2233d604ea16ec53f43da4d2108120a85760243c6def5121130265f469ffb3b3</citedby><cites>FETCH-LOGICAL-c388t-a2233d604ea16ec53f43da4d2108120a85760243c6def5121130265f469ffb3b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0167527303004121$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15815411$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15193826$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Airaksinen, K.E.Juhani</creatorcontrib><creatorcontrib>Koivikko, Minna L.</creatorcontrib><creatorcontrib>Niemelä, Matti J.</creatorcontrib><creatorcontrib>Tahvanainen, Kari U.O.</creatorcontrib><creatorcontrib>Linnaluoto, Markku</creatorcontrib><creatorcontrib>Huikuri, Heikki V.</creatorcontrib><title>Diabetes and haemodynamic reactions to acute coronary occlusion</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Background: The risk of early sudden death before hospital admission is higher in diabetic than non-diabetic men with acute myocardial infarction and autonomic nervous activity may modify the clinical outcome of abrupt coronary occlusion. Since diabetes mellitus may interfere with autonomic and myocardial function, we decided to study whether diabetes alters autonomic and haemodynamic responses to acute coronary occlusion.
Methods: We analyzed the changes in heart rate, heart rate variability and blood pressure, and the occurrence of ventricular ectopy during a 2-min coronary occlusion in 238 non-diabetic and 32 diabetic patients referred for single vessel coronary angioplasty. The ranges of non-specific responses were determined by analyzing a control group of 19 patients with no ischaemia during a 2-min balloon inflation in a totally occluded coronary artery.
Results: Diabetic patients were more often (
p<0.05) female, but there were no significant differences in the occluded vessel or incidence of ST changes or chest pain during coronary occlusion between the groups. Incidence of significant heart rate reactions and ventricular arrhythmias was comparable in both groups. Systolic blood pressure decreased (
p=0.01) in the diabetic patients during coronary occlusion, but did not change significantly in the non-diabetic group. Coronary occlusion caused more often (34% vs. 14%,
p<0.01) a significant decrease in blood pressure in diabetic patients
. Logistic regression models developed to analyze the significance of diabetes while controlling for baseline variables and signs of ischaemia identified diabetes to be an independent predictor of hypotensive reactions (odds ratio [OR] 2.9, 95% confidence intervals 1.1–7.8,
p<0.05), while female gender and high short-term heart rate variability were other independent predictors of hypotensive reactions.
Conclusions: Diabetic patients often develop significant hypotension during the early phase of acute coronary occlusion. This abnormality may be related to diabetic cardiomyopathy and impairment of baroreflex-mediated regulation of circulation. Predisposition to hypotension may contribute to the observed differences in the clinical presentation and outcome of acute coronary events.</description><subject>Autonomic Nervous System - physiopathology</subject><subject>Autonomic Nervous System Diseases - etiology</subject><subject>Autonomic Nervous System Diseases - physiopathology</subject><subject>Autonomic neuropathy</subject><subject>Baroreflex</subject><subject>Baroreflexes</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>Cardiology. Vascular system</subject><subject>Case-Control Studies</subject><subject>Coronary Disease - complications</subject><subject>Coronary Disease - physiopathology</subject><subject>Coronary heart disease</subject><subject>Diabetes Complications</subject><subject>Female</subject><subject>Heart</subject><subject>Heart rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypotension - etiology</subject><subject>Hypotension - physiopathology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Ventricular Premature Complexes - etiology</subject><subject>Ventricular Premature Complexes - physiopathology</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1r3DAURUVISaaT_INQvGl3dvVtzyYhJE1aCHTTrsWbp2eiwbZSyS7Mv6_CDKSrrN7inXu5HMauBG8EF_brrgk7hOQbyblquG041ydsJbpW16I1-pStCtbWRrbqnH3MeccLsdl0Z-xcGLFRnbQrdnMfYEsz5QomXz0DjdHvJxgDVokA5xCnXM2xAlxmqjCmOEHaVxFxWHJ5XrAPPQyZLo93zX4_fPt1971--vn44-72qUbVdXMNUirlLdcEwhIa1WvlQXspeCckh860lkut0HrqjZBCKC6t6bXd9P1WbdWafTn0vqT4Z6E8uzFkpGGAieKSXSu5NEbaAuoDiCnmnKh3LymMZbMT3L2Kczt3EOdexTluXdFSYp-O_ct2JP8WOpoqwOcjABlh6BNMGPJ_XCeMLrPX7PrAUbHxN1ByGQNNSD4kwtn5GN5f8g-XlYx1</recordid><startdate>20040601</startdate><enddate>20040601</enddate><creator>Airaksinen, K.E.Juhani</creator><creator>Koivikko, Minna L.</creator><creator>Niemelä, Matti J.</creator><creator>Tahvanainen, Kari U.O.</creator><creator>Linnaluoto, Markku</creator><creator>Huikuri, Heikki V.</creator><general>Elsevier Ireland Ltd</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040601</creationdate><title>Diabetes and haemodynamic reactions to acute coronary occlusion</title><author>Airaksinen, K.E.Juhani ; Koivikko, Minna L. ; Niemelä, Matti J. ; Tahvanainen, Kari U.O. ; Linnaluoto, Markku ; Huikuri, Heikki V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c388t-a2233d604ea16ec53f43da4d2108120a85760243c6def5121130265f469ffb3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Autonomic Nervous System - physiopathology</topic><topic>Autonomic Nervous System Diseases - etiology</topic><topic>Autonomic Nervous System Diseases - physiopathology</topic><topic>Autonomic neuropathy</topic><topic>Baroreflex</topic><topic>Baroreflexes</topic><topic>Biological and medical sciences</topic><topic>Blood pressure</topic><topic>Cardiology. Vascular system</topic><topic>Case-Control Studies</topic><topic>Coronary Disease - complications</topic><topic>Coronary Disease - physiopathology</topic><topic>Coronary heart disease</topic><topic>Diabetes Complications</topic><topic>Female</topic><topic>Heart</topic><topic>Heart rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypotension - etiology</topic><topic>Hypotension - physiopathology</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Ventricular Premature Complexes - etiology</topic><topic>Ventricular Premature Complexes - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Airaksinen, K.E.Juhani</creatorcontrib><creatorcontrib>Koivikko, Minna L.</creatorcontrib><creatorcontrib>Niemelä, Matti J.</creatorcontrib><creatorcontrib>Tahvanainen, Kari U.O.</creatorcontrib><creatorcontrib>Linnaluoto, Markku</creatorcontrib><creatorcontrib>Huikuri, Heikki V.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Airaksinen, K.E.Juhani</au><au>Koivikko, Minna L.</au><au>Niemelä, Matti J.</au><au>Tahvanainen, Kari U.O.</au><au>Linnaluoto, Markku</au><au>Huikuri, Heikki V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diabetes and haemodynamic reactions to acute coronary occlusion</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2004-06-01</date><risdate>2004</risdate><volume>95</volume><issue>2</issue><spage>237</spage><epage>244</epage><pages>237-244</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><coden>IJCDD5</coden><abstract>Background: The risk of early sudden death before hospital admission is higher in diabetic than non-diabetic men with acute myocardial infarction and autonomic nervous activity may modify the clinical outcome of abrupt coronary occlusion. Since diabetes mellitus may interfere with autonomic and myocardial function, we decided to study whether diabetes alters autonomic and haemodynamic responses to acute coronary occlusion.
Methods: We analyzed the changes in heart rate, heart rate variability and blood pressure, and the occurrence of ventricular ectopy during a 2-min coronary occlusion in 238 non-diabetic and 32 diabetic patients referred for single vessel coronary angioplasty. The ranges of non-specific responses were determined by analyzing a control group of 19 patients with no ischaemia during a 2-min balloon inflation in a totally occluded coronary artery.
Results: Diabetic patients were more often (
p<0.05) female, but there were no significant differences in the occluded vessel or incidence of ST changes or chest pain during coronary occlusion between the groups. Incidence of significant heart rate reactions and ventricular arrhythmias was comparable in both groups. Systolic blood pressure decreased (
p=0.01) in the diabetic patients during coronary occlusion, but did not change significantly in the non-diabetic group. Coronary occlusion caused more often (34% vs. 14%,
p<0.01) a significant decrease in blood pressure in diabetic patients
. Logistic regression models developed to analyze the significance of diabetes while controlling for baseline variables and signs of ischaemia identified diabetes to be an independent predictor of hypotensive reactions (odds ratio [OR] 2.9, 95% confidence intervals 1.1–7.8,
p<0.05), while female gender and high short-term heart rate variability were other independent predictors of hypotensive reactions.
Conclusions: Diabetic patients often develop significant hypotension during the early phase of acute coronary occlusion. This abnormality may be related to diabetic cardiomyopathy and impairment of baroreflex-mediated regulation of circulation. Predisposition to hypotension may contribute to the observed differences in the clinical presentation and outcome of acute coronary events.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>15193826</pmid><doi>10.1016/j.ijcard.2003.06.004</doi><tpages>8</tpages></addata></record> |
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| ispartof | International journal of cardiology, 2004-06, Vol.95 (2), p.237-244 |
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| subjects | Autonomic Nervous System - physiopathology Autonomic Nervous System Diseases - etiology Autonomic Nervous System Diseases - physiopathology Autonomic neuropathy Baroreflex Baroreflexes Biological and medical sciences Blood pressure Cardiology. Vascular system Case-Control Studies Coronary Disease - complications Coronary Disease - physiopathology Coronary heart disease Diabetes Complications Female Heart Heart rate Hemodynamics Humans Hypotension - etiology Hypotension - physiopathology Logistic Models Male Medical sciences Middle Aged Ventricular Premature Complexes - etiology Ventricular Premature Complexes - physiopathology |
| title | Diabetes and haemodynamic reactions to acute coronary occlusion |
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