HUMAN CORONARY MICROVESSELS IN DIABETES AND ISCHEMIA - MORPHOMETRIC STUDY OF AUTOPSY MATERIAL

The objective of this study was to test the hypothesis that excessive severity of ischaemic heart disease in diabetics is due, in part, to c apillary inadequacy. Sections from autopsied hearts of diabetic patien ts with and without myocardial infarction as well as from those of pat ients with infarcts and no diabetes were used for morphometric studies of intramural microvessels in areas without infarction. Normoglycaemi c patients with normal hearts were also examined. Two to five transver se sections from each of 44 hearts (stained with methenamine silver) w ere examined for capillary numerical density, capillary to myofibre ra tios, and myofibre diameters. Averages for each case and totals for ea ch group were calculated and compared. Normoglycaemic patients with in farcts had increased morphometric values. Diabetics with infarcts had significantly lower capillary densities than the other groups. In conc lusion, it is suggested that in diabetes there is an inadequate ischae mia-induced, reactive angiogenesis. This may contribute towards increa sed myocardial vulnerability in further ischaemic injury and perhaps t o diabetic cardiomyopathy.