CORONARY-ARTERY DIAMETER AND LEFT-VENTRICULAR FUNCTION IN PATIENTS ONMAINTENANCE HEMODIALYSIS-TREATMENT - COMPARISON BETWEEN DIABETIC AND NONDIABETIC PATIENTS

Background/Aims: This study examined the role of diabetes mellitus on determining left ventricular function by evaluating coronary artery di ameter in patients with end-stage renal disease on maintenance hemodia lysis treatment. Methods: We studied 12 diabetic and 12 nondiabetic pa tients on maintenance hemodialysis treatment without significant steno ses of the major epicardial coronary arteries. Patients were matched f or age, sex distribution, duration of dialysis and incidence of major coronary risk factors. Left ventricular wall thickness (septal and pos terior walls) and left ventricular diameter (end-diastolic and systoli c phases), were measured by echocardiography. Hemodynamic measurements and coronary angiography were performed on the day of hemodialysis an d coronary artery diameter at the proximal and mid portion of three ma jor coronary arteries were measured using the computed densitometry me thod. Results: Right and left anterior descending and circumflex coron ary artery diameters were all significantly smaller and the frequency of coronary artery calcification was higher in diabetic (58%) compared to nondiabetic (8%) patients. Although there were no significant diff erences in left ventricular wall thickness, left ventricular diameter, mean right atrial pressure and cardiac index between the two groups, left ventricular end-diastolic pressure was significantly higher in di abetic (22 +/- 9 mm Hg) compared to nondiabetic patients (14 +/- 5 mm Hg). Conclusion: Despite that there were no significant stenoses of th e major epicardial coronary arteries, diffuse luminal narrowing of the epicardial coronary arteries in diabetic patients on maintenance hemo dialysis treatment was associated with increased left ventricular end- diastolic pressure.