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Keymel S.,University Dusseldorf Medical Faculty | Heiss C.,University Dusseldorf Medical Faculty | Kleinbongard P.,University of Duisburg - Essen | Kelm M.,University Dusseldorf Medical Faculty | Lauer T.,University Dusseldorf Medical Faculty
Hormone and Metabolic Research | Year: 2011

Patients with diabetes mellitus (DM) have an increased cardiovascular morbidity and mortality. There is increasing evidence that diabetes mellitus is associated with pathological hemorheological alterations, which might contribute to impaired coronary blood flow in coronary artery disease (CAD). We hypothesize that red blood cell (RBC) deformability is impaired in diabetic patients with CAD in comparison to nondiabetic patients with CAD. RBC deformability was measured in 21 patients with CAD and type 2 diabetes mellitus (CAD+DM) and 24 patients with CAD (CADDM). RBC deformability was measured by the Laser-assisted optical rotational cell analyzer by determining the elongation index (EI). RBC deformability was reduced in patients with CAD+DM in comparison to patients with CADDM (EI @ 1.12Pa 0.2360.008 vs. 0.2600.005, p=0.007). Inverse univariate correlations were found between the EI @ 1.12Pa and plasma glucose concentration (r=0.57; p<0.001) and HbA(r=0.45; p=0.002). Multivariate linear regression analysis identified plasma glucose concentration as the independent predictor of RBC deformability (=0.58; p=0.007) thereby indicating that increased glucose concentrations determine RBC deformability in diabetic patients with CAD. In patients with CAD, diabetes mellitus leads to an impairment of RBC deformability which might contribute to increased morbidity of diabetic patients with CAD. © Georg Thieme Verlag KG Stuttgart · New York.

Heusch P.,University Dusseldorf Medical Faculty | Wittsack H.-J.,University Dusseldorf Medical Faculty | Blondin D.,University Dusseldorf Medical Faculty | Ljimani A.,University Dusseldorf Medical Faculty | And 8 more authors.
Journal of Magnetic Resonance Imaging | Year: 2014

Purpose To investigate non-contrast-enhanced arterial spin labeling (ASL) MRI for functional assessment of transplanted kidneys at 1.5 Tesla (T) and 3T. Materials and Methods This study was approved by the local ethics committee, and written informed consent was obtained from all participants. Ninety eight renal allograft recipients (mean age, 51.5 ± 14.6 years) were prospectively included in this study. ASL MRI was performed at 1.5T (n = 65) and 3T (n = 33) using a single-slice flow-sensitive alternating inversion recovery true-fast imaging with steady-state precession (FAIR True-FISP) sequence in the paracoronal plane. ASL perfusion was regional analyzed for the renal cortex on parameter maps. ASL was compared between patients with good or moderate allograft function (Group a; estimated glomerular filtration rate [eGFR] > 30 mL/min/1.73 m2) and patients with heavily impaired allograft function (Group b; eGFR ≤ 30 mL/min/1.73 m2) and correlated to renal function as determined by eGFR. Results ASL perfusion and eGFR were comparable at 1.5T (246.9 ± 66.8 mL/100 g/min and 41.9 ± 22.7 mL/min/1.73 m2) and 3T (236.5 ± 102.3 mL/100 g/min and 35.9 ± 22.9 mL/min/1.73 m2). ASL perfusion was significantly higher in group a (282.7 ± 60.8 mL/100 g/min) as compared to group b (178.2 ± 63.3 mL/100 g/min) (P < 0.0001). ASL perfusion values exhibited a significant correlation with renal function as determined by eGFR (r = 0.59; P < 0.0001). Conclusion Cortical ASL perfusion values differ between patients with good or moderate allograft function and poor allograft function and correlate significantly with allograft function. Our results highlight the potential of ASL MRI for functional evaluation of renal allografts. © 2013 Wiley Periodicals, Inc. © 2013 Wiley Periodicals, Inc.

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