Nebivolol in older adults with heart failure: reduced rates for seniors?

摘要

The diagnosis of diabetes mellitus (DM) carries with it many serious consequences, the most serious of which is coronary artery disease (1). The outcome of diabetic patients with coronary artery disease is significantly worse than that of nondiabetic patients. In particular, it is the subset of diabetic patients that develop microvascular complications that is at greatest risk for myocardial infarction, left ventricular dysfunction, and death (2). In this issue of the Journal, Womack et al. (3) use high-resolution contrast-enhanced ultrasound (CEU) to examine capillary blood flow responses to handgrip exercise in diabetic patients. A defective capillary blood volume response was observed almost exclusively in the DM patients who had developed microvascular disease. Unlike microvascular complications, however, this defective capillary response was unrelated to the duration of disease.