Effects of prediabetes and diabetes on left ventricular and coronary microvascular functions

Abstract Background Coronary flow reserve (CFR) provides independent prognostic information in diabetic patients with known or suspected coronary artery disease. However, there have been no substantial data to evaluate CFR in prediabetics. Accordingly, we aimed to evaluate CFR in subjects with prediabetes using second harmonic transthoracic Doppler echocardiography. Methods and Results We measured CFR of 65 subjects with prediabetes, 45 patients with overt type 2 diabetes, and 43 sex and age matched normoglycemic healthy subjects with normal glucose tolerance. Ages, gender, existence of hypertension or hypercholesterolemia, smoking status were similar among the groups. CFR was significantly lower in diabetics (2.15 ± 0.39) than in prediabetics (2.39 ± 0.45) and controls (2.75 ± 0.35); in addition, it was significantly lower in prediabetics than controls. Only 2 (5%) of control subjects had abnormal CFR ( P  = 0.04), fasting glucose level (r = − 0.27, P  = 0.001), postprandial glucose level (r = 0.43, P P P  = 0.009), mitral A velocity (r = − 0.27, P  = 0.001) and Tei index (r = − 0.19, P  = 0.02), whereas mitral E/A ratio, mitral E m (r = 0.18, P  = 0.02), mitral E m/ A m ratio (r = 0.23, P  = 0.004) were significantly and positively correlated with CFR. Conclusion CFR is impaired in subjects with prediabetics, but this impairment is not as severe as that in diabetics.