The myocardial perfusion scintigraphy in asymptomatic diabetic patients

Introduction: Asymptomatic diabetic patients are at increased risk of cardiovascular complications. Myocardial perfusion scan may be effective in risk evaluation in this population. Methods: 106 asymptomatic diabetic patients (age: min: 37, max: 82, mean: 57.73±8.88), including 56 females (52.8%) and 50 males (47.2%) were enrolled in the study. Myocardial perfusion scintigraphy was performed by Gated Single Photon Emission Computed Tomography (Gated-SPECT) method. Perfusion and function status was evaluated by qualitative and semi-quantitative parameters. Results: By visual analysis totally 40 out of 106 patients (37.7%) showed abnormal scan. From which, 26(24.5%) showed involvement in one, 13(12.3%) in two, and 1(0.9%) in all three vessel territories. By semi-quantitative method, from 103 patients, 28 (27.2%) were abnormal and 75 (72.8%) were normal. From all the asymptomatic diabetic patients, 11 patients (10.4%) had dilated left ventricles. Transient Ischemic Dilation (TID) was noted in 10 patients (9.4%), and Transient Right ventricle visualization in 7 patients (6.6%). Heart failure (EF<45%) was observed in 14% of asymptomatic diabetic patients. From underlying factors, long duration of diabetes disease correlated to abnormal myocardial perfusion imaging (MPI) findings (Odds Ratio: 2.77; CI: 1.07-7.12). Severe coronary artery disease leading to the pattern of severe ischemia or infarction in MPI, was significantly higher in men than women (P=0.05). Also smoking correlated with higher involvement of LAD coronary artery (P=0.011) and as compared with RCA territory (P=0.079). Conclusion: In asymptomatic diabetic patients myocardial perfusion scintigraphy can be used in early diagnosis of coronary artery disease (CAD) and can be suggested as screening study in these patients.

The myocardial perfusion scintigraphy in asymptomatic diabetic patients Keywords:

Asymptomatic ischemia , Diabetes Mellitus , Myocardial perfusion scintigraphy , Gated SPECT