First Department of Cardiology, Athens Medical School, Hippokration Hospital, Holargos, Greece.
Diabetes Metab. 2009 Sep;35(4):299-304. doi: 10.1016/j.diabet.2009.01.005. Epub 2009 Jul 30.
Local coronary and systemic inflammation is pronounced in patients with diabetes mellitus (DM). Intracoronary thermography detects local inflammation and C-reactive protein (CRP) is a marker of systemic inflammation. We investigated whether or not, in patients with DM, thermal heterogeneity of culprit lesions (CLs) correlates with that of non-culprit lesions (NCLs) and with systemic inflammation.
We included DM patients who had two angiographically significant lesions and were undergoing percutaneous coronary intervention. We measured the temperature difference (DeltaT) between the lesion and proximal vessel wall.
We included 104 (n=208 lesions) patients: 32 (n=64 lesions) had DM and 72 (n=144 lesions) were non-DM (control group). DeltaT was increased in DM in both CLs and NCLs (CLs: DM=0.12+/-0.06 degrees C; no DM=0.06+/-0.04 degrees C; P<0.01 versus NCLs: DM=0.13+/-0.08 degrees C versus no DM=0.06+/-0.05 degrees C; P<0.01). Patients with DM had similar DeltaT in CLs and NCLs (P=0.49). A linear correlation was detected between heat production in all lesions and CRP (R=0.45; P<0.01), which was attributed to the correlation of DeltaT in lesions of patients with DM and CRP (R=0.32; P<0.01). In lesions of patients with low CRP, a greater rate of discrepancy was found, as 100% of lesions in patients with DM versus 66.1% of lesions of patients without DM had a high DeltaT in one or both lesions (P<0.01).
In patients with DM, local inflammatory activation is diffuse and correlates with systemic inflammation. However, low systemic inflammatory activation does not always predict an increase in local thermal heterogeneity.
糖尿病（DM）患者局部冠状动脉和全身炎症明显。冠状动脉内热成像可检测局部炎症，C 反应蛋白（CRP）是全身炎症的标志物。我们研究了 DM 患者的罪犯病变（CL）和非罪犯病变（NCL）的热异质性是否与全身炎症相关。
我们纳入了接受经皮冠状动脉介入治疗的有 2 个血管造影显著病变的 DM 患者。我们测量了病变与近段血管壁之间的温差（DeltaT）。
我们纳入了 104 例（208 个病变）患者：32 例（64 个病变）患有 DM，72 例（144 个病变）为非 DM（对照组）。DM 的 CL 和 NCL 中 DeltaT 均增加（CL：DM=0.12+/-0.06°C；非 DM=0.06+/-0.04°C；P<0.01；与 NCL 相比：DM=0.13+/-0.08°C 与非 DM=0.06+/-0.05°C；P<0.01）。DM 患者 CL 和 NCL 中的 DeltaT 相似（P=0.49）。所有病变的产热量与 CRP 呈线性相关（R=0.45；P<0.01），这归因于 DM 患者病变的 DeltaT 与 CRP 之间的相关性（R=0.32；P<0.01）。在 CRP 水平较低的患者中，差异程度更大，100%的 DM 患者病变与 66.1%的非 DM 患者病变中，1 个或 2 个病变均有较高的 DeltaT（P<0.01）。
DM 患者的局部炎症激活是弥漫性的，与全身炎症相关。然而，全身炎症激活程度较低并不总是预示着局部热异质性增加。
