scholarly journals Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

2013 ◽  
Vol 46 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Gláucia Celeste Rossatto Oki ◽  
Elizabeth João Pavin ◽  
Otávio Rizzi Coelho ◽  
Maria Cândida R. Parisi ◽  
Raitany C. Almeida ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Myocardial Perfusion ◽  
Myocardial Perfusion Scintigraphy ◽  
Left Ventricular ◽  
Silent Myocardial Ischemia ◽  
Diabetic Patients ◽  
Perfusion Scintigraphy ◽  
Asymptomatic Patients ◽  
History Of ◽  
Artery Disease

OBJECTIVE: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. MATERIALS AND METHODS: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with 99mTc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. RESULTS: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). CONCLUSION: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia.

Myocardial perfusion scintigraphy: image interpretation

2017 ◽  
Author(s):  
Nikant Sabharwal ◽  
Parthiban Arumugam ◽  
Andrew Kelion
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Myocardial Perfusion Scintigraphy ◽  
Photon Emission ◽  
Image Interpretation ◽  
Left Ventricular ◽  
Emission Computed Tomography ◽  
Perfusion Scintigraphy ◽  
Artery Disease

This chapter focuses on image interpretation in myocardial perfusion scintigraphy. It covers planar acquisitions, the general approach to reporting single photon emission computed tomography (SPECT) images, and both qualitative and quantitative evaluation of tomographic slices. Detail is also provided on gated SPECT and attenuation correction, as well as a range of artefacts including image, instrumentation-related, and patient-related artefacts. Information is provided on abnormal appearances in coronary artery disease, perfusion defects, and indirect markers of severe coronary artery disease. The chapter also covers interpretation in left ventricular dysfunction and appearances in non-coronary cardiac disease, and includes a section on writing a useful report.

scholarly journals Evidence for a Specific Diabetic Cardiomyopathy: An Observational Retrospective Echocardiographic Study in 656 Asymptomatic Type 2 Diabetic Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Isabelle Pham ◽  
Emmanuel Cosson ◽  
Minh Tuan Nguyen ◽  
Isabela Banu ◽  
Isabelle Genevois ◽  
...  
Keyword(s):  
Diabetic Cardiomyopathy ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Silent Myocardial Ischemia ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Asymptomatic Patients ◽  
Artery Disease ◽  
Type 2 Diabetic

Aim. Our aim was to assess the prevalence of subclinical diabetic cardiomyopathy, occurring among diabetic patients without hypertension or coronary artery disease (CAD).Methods. 656 asymptomatic patients with type 2 diabetes for 14 ± 8 years (359 men, 59.7 ± 8.7 years old, HbA1c 8.7 ± 2.1%) and at least one cardiovascular risk factor had a cardiac echography at rest, a stress cardiac scintigraphy to screen for silent myocardial ischemia (SMI), and, in case of SMI, a coronary angiography to screen for silent CAD.Results. SMI was diagnosed in 206 patients, and 71 of them had CAD. In the 157 patients without hypertension or CAD, left ventricular hypertrophy (LVH: 24.1%) was the most frequent abnormality, followed by left ventricular dilation (8.6%), hypokinesia (5.3%), and systolic dysfunction (3.8%). SMI was independently associated with hypokinesia (odds ratio 14.7 [2.7–81.7],p<0.01) and systolic dysfunction (OR 114.6 [1.7–7907],p<0.01), while HbA1c (OR 1.9 [1.1–3.2],p<0.05) and body mass index (OR 1.6 [1.1–2.4],p<0.05) were associated with systolic dysfunction. LVH was more prevalent among hypertensive patients and hypokinesia in the patients with CAD.Conclusion. In asymptomatic type 2 diabetic patients, diabetic cardiomyopathy is highly prevalent and is predominantly characterized by LVH. SMI, obesity, and poor glycemic control contribute to structural and functional LV abnormalities.

scholarly journals Prognostic value of myocardial perfusion scintigraphy in asymptomatic patients with diabetes mellitus at high cardiovascular risk: 5-year follow-up of the prospective multicenter BARDOT trial

2021 ◽  
Author(s):  
Federico Caobelli ◽  
◽  
Philip Haaf ◽  
Gianluca Haenny ◽  
Matthias Pfisterer ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Myocardial Perfusion ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Myocardial Perfusion Scintigraphy ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Perfusion Scintigraphy ◽  
High Cardiovascular Risk

Abstract Background The Basel Asymptomatic High-Risk Diabetics’ Outcome Trial (BARDOT) demonstrated that asymptomatic diabetic patients with an abnormal myocardial perfusion scintigraphy (MPS) were at increased risk of major adverse cardiovascular events (MACEs) at 2-year follow-up. It remains unclear whether this finding holds true even for a longer follow-up. Methods Four hundred patients with type 2 diabetes, neither history nor symptoms of coronary artery disease (CAD), were evaluated clinically and with MPS. Patients were followed up for 5 years. Major adverse cardiovascular events (MACEs) were defined as all-cause death, myocardial infarction, or late coronary revascularization. Results At baseline, an abnormal MPS (SSS ≥ 4 or SDS ≥ 2) was found in 87 of 400 patients (22%). MACE within 5 years occurred in 14 patients with abnormal MPS (16.1%) and in 22 with normal scan (1.7%), p = 0.009; 15 deaths were recorded. Patients with completely normal MPS (SSS and SDS = 0) had lower rates of MACEs than patients with abnormal scans (2.5% vs. 7.0%, p = 0.032). Patients with abnormal MPS who had undergone revascularization had a lower mortality rate and a better event-free survival from MI and revascularization than patients with abnormal MPS who had either undergone medical therapy only or could not be revascularized (p = 0.002). Conclusions MPS may have prognostic value in asymptomatic diabetic patients at high cardiovascular risk over a follow-up period of 5 years. Patients with completely normal MPS have a low event rate and may not need retesting within 5 years. Patients with an abnormal MPS have higher event rates and may benefit from a combined medical and revascularization approach.

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