Investigation of the effects of diabetes mellitus on left internal thoracic artery flow patterns in patients scheduled to undergo coronary bypass graft surgery

Abstract

Diabetes mellitus (DM) plays a key role in the formation and prognosis of cardiovascular diseases. In this study, we aimed to investigate the effects of DM and glycemic control on left internal thoracic artery (LITA) Doppler flow in patients scheduled to undergo coronary artery bypass graft (CABG) surgery. Patients who were hospitalized with a planned isolated CABG operation to our clinic between October 1, 2019 and March 1, 2020 were consecutively included in this prospective study. The patients were divided into three groups as those without DM (Group 1), those with DM and HbA1c values of below 7.5 (Group 2), and those with DM and HbA1c values of 7.5 and above (Group 3). The differences between the LITA Doppler flow patterns of the patients were analyzed. The mean ages of Group 1 (n =103), Group 2 (n =42), and Group 3 (n =47) were 59.8 ± 9.6 years, 60.5 ± 9.3 years, and 61.9 ± 8.1 years, respectively. The groups differed in terms of diameter, volume, Vmax, pulsality index (PI), and resistive index (RI) values, both when the groups were compared among themselves (P < .001, for all), and when they were compared between those with (Groups 2 and 3) and without DM (Group 1) (P < .001, for all). Volume (R=-0.627, P < .001) and Vmax (R=-.450, P < .001) were moderately negatively correlated, while PI (R=.523, P < .001) and RI (R=0.598, P < 0.001) were moderately positively correlated with HbA1c levels. In this study, we showed that increased HbA1c levels may be associated with significant functional and structural changes of LITA.