A research project completed by Dr. Dai Zhengxue of the department of cardiovascular medicine, Xijing hospital, the fourth Military Medical University proved that patients suffering from coronary heart disease associated with diabetes mellitus usually have insufficient collateral circulation formation of the coronary artery.
Dr. Dai et al selected 212 cases of diabetes mellitus undergone coronary artery angiography as of Aug. 1st,1995 to Oct. 30th,2000 (excluding the cases exhibited normal angiography and those with occlusion of less than 75 %) as the diabetic group; another group of 212 cases were selected from patients with diabetes mellitus and at least one branch of the coronary artery was occluded ≥75 % as that of the control group. According to the grading method of Rentrop, the collateral circulation of the evaluated and those undergone left ventriculography the ejection fraction of the left ventricle was measured.
The results revealed that among the two groups, there were no significant differences found in the aspects of age in average, gender, physical status, history of smoking, myocardial infarction, unstable angina pectoris and the changes of serum lipids. The condition of coronary artery occlusion was similar in between the two groups, however, the number of the diseased arteries in the diabetic group was significantly more than that in the control group ( of 1.78±0.60 and 1.43±0.62 branches, respectively, P<0.01); the average collateral branches score in the two groups were respectively 2.32±2.11 and 2.68±2.26 (P<0.01); the blood ejection fraction of the left ventricle in the two groups were (48±27) % and (61±22) %, respectively, (P<0.01).
The researchers considered that the formation of collateral circulation was insufficient and the ejection fraction score of the left ventricle was lower than that in the control groups. This was a fact indicating diabetes mellitus being an inhibition factor for coronary artery collateral circulation formation. Along with a whole scale interpretation of the mechanism of coronary artery collateral circulation formation and its degenerative process, a new regime of management will hopefully be established for patient with coronary artery disease.
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