Coronary circulatory function abnormalities in insulin resistance: insights from positron emission tomography.

Traditionally, assessment of coronary circulatory function has been complex, requiring invasive techniques, including quantitative coronary angiography, intracoronary flow velocity probes, and pharmacologic stressor agents. However, radiotracer-based techniques for noninvasive measurement of myocardial blood flow are now available. Studies using these new techniques demonstrate that insulin resistance is associated with functional disturbances of the coronary circulation. Conversely, insulin infusion improves coronary flow, even in the setting of type 2 diabetes mellitus and coronary artery disease.