scholarly journals The Role of Myocardial Perfusion Imaging in Patients with Diabetes Mellitus

2021 ◽  
Vol 18 (5) ◽  
pp. 31-37
Author(s):  
Raluca Mititelu ◽  
Cătălin Mazilu ◽  
Adina Mazilu ◽  
Silviu Stanciu
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Perfusion Imaging ◽  
Myocardial Perfusion Spect ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Perfusion Spect ◽  
Perfusion Defects

Abstract Diabetes mellitus is a complex pathology with increasing incidence, associated with an increased risk of coronary heart disease. Myocardial perfusion imaging (MPI) is an important diagnostic tool for the evaluation of coronary artery disease (CAD), with a high prognostic value. Objective. The aim of this study was to evaluate the role of stress-rest MPI in the assessment of patients with DM and suspected or confirmed CAD. Method. We performed a retrospective analysis of 128 patients who underwent stress-rest MPI in our department, all of them with coronary angiography (CA) available. All patients underwent stress rest myocardial perfusion SPECT using a 1-day or 2-day protocol. The radiopharmaceuticals used were 99m-Tc-MIBI or tetrofosmin. The study was performed with a gated protocol SPECT, synchronous with the ECG, using a dual-head gamma camera. Patients were divided in 4 subgroups based on the presence of DM and of significant CA changes. Results. In the group of patients with significant coronary disease on CA and previously diagnosed DM, number of perfusion defects on the stress-rest MPI were higher and also the presence of systolic disfunction and the severity of defects. Our results support the idea that the severity and extent of myocardial perfusion defects are greater in diabetic patients than in non-diabetic patients. Conclusions. We can consider myocardial perfusion SPECT with 99mTc-labeled agents as a feasible method for the diagnosis and evaluation of CAD and for the management of diabetic patients.

scholarly journals Role of the radiopharmacist in myocardial perfusion imaging safety as part of a multidisciplinary team

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
A Jimenez-Heffernan ◽  
C Salgado-Garcia ◽  
T Aroui-Luquin ◽  
E Sanchez De Mora ◽  
AM Santos-Bueno
Keyword(s):  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Perfusion Imaging ◽  
Multidisciplinary Team ◽  
Clinical Activity ◽  
Spect Mpi ◽  
Funding Sources ◽  
Increased Risk ◽  
Safe Performance

Abstract Funding Acknowledgements Type of funding sources: None. Background Vasodilator stress agents have limitations and clinical contraindications that must be identified before patients undergo myocardial perfusion imaging (MPI). Clinical pharmacy may be viewed as part of radiopharmacy practice enabling radiopharmacists to recognize patients with an increased risk of complications and identify relative and absolute contraindications for vasodilator cardiac stress. Purpose Assessment of the role of the radiopharmacist in a multidisciplinary team focused on the safe performance of regadenoson and adenosine stress MPI. Methods We studied 800 patients undergoing SPECT MPI (55.9% female, mean age 67.1 ±11.4 y, range: 24-90 y). Gender, age, medical history, medications, drug allergies and contraindications for stress testing were registered and the resulting recommendations were reported to the nuclear physician in charge of the patient. Results The table displays the findings and recommendations to the nuclear physician. No contraindications were found in 77.2% of patients. Conclusion With a systematic approach, the radiopharmacist detected a drug interaction or clinical contraindication in approximately 25% of patients and the reported recommendations were well received and accepted by the nuclear physicians who changed their approach with the resulting increased patient safety. The clinical activity of radiopharmacists can be enhanced and many opportunities will be identified. Physicians and nurses should be aware of the potential role of radiopharmacists as clinical providers in Nuclear Medicine departments.

scholarly journals Correlation between myocardial perfusion imaging findings and future cardiac events in patients with type 2 diabetes mellitus

2021 ◽  
pp. 62-62
Author(s):  
Sinisa Stankovic ◽  
Dragana Sobic-Saranovic ◽  
Valentina Soldat-Stankovic ◽  
Vera Artiko ◽  
Zvezdana Rajkovaca ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Perfusion Imaging ◽  
Perfusion Defect ◽  
Difference Score ◽  
Stress Perfusion ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Stress Score

Introduction/Objective. Myocardial perfusion imaging (MPI) is clinically useful for the evaluation of coronary artery disease (CAD) in patients with diabetes mellitus (DM). However, the prevalence of ischemia and its ability to predict future cardiac events is less clear. The aim was to determine the incidence of cardiac events in diabetic patients and relationship between them and MPI findings. Methods. Two cohorts of patients, 98 diabetics and 100 non-diabetics, with medium- to high-risk of CAD without previous coronary revascularization were studied prospectively. All of them were outpatients underwent 99mTc-sestamibi MPI with dipyridamole. The data about cardiac events were collected during follow-up period of two years. Results. Cardiac events occurred in 17.3% diabetics and in 8% non-diabetics (p = 0.048). Diabetics had shorter estimated event-free time 24.7 months (95% CI 23.2-26.2) versus non-diabetics 28.5 months (95% CI 27.4-29.5) (p = 0.046). The independent predictors of cardiac events were male sex (p = 0.010), previous myocardial infarction (p < 0.001), presence of the symptoms of angina (p = 0.014) and all variables derived from MPI findings. After adjustment for variables derived from MPI findings, the significant predictors in diabetics were size of stress perfusion defect (p = 0.022), summed stress score (p = 0.011) and summed difference score (p = 0.044). Conclusion. In diabetic patients, the cumulative rate of cardiac events was higher and the event-free survival was worse. MPI could help in prediction of cardiac events in diabetics and the most important predictors were size of stress perfusion defect, summed stress score and summed difference score.

The Role of Myocardial Perfusion Imaging in the Clinical Evaluation of Coronary Artery Disease in Women

2006 ◽  
Vol 3 (2) ◽  
pp. 68-72
Author(s):  
Jennifer Mieres ◽  
Leslee J Shaw ◽  
Robert C Hendel ◽  
D Douglas Miller ◽  
Robert Bonow ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Clinical Evaluation ◽  
Perfusion Imaging ◽  
Artery Disease

scholarly journals Prognostic Assessment of Diabetics Using Myocardial Perfusion Imaging: Diabetes Mellitus is Still a Coronary Artery Disease Equivalent

2017 ◽  
Vol 11 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Andrea De Lorenzo ◽  
Victor F. Souza ◽  
Leticia Glerian ◽  
Ronaldo SL Lima
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Diabetic Patients ◽  
Death Rates ◽  
Prognostic Assessment ◽  
Increased Risk ◽  
Risk Condition ◽  
Artery Disease

Background:Even though diabetes mellitus (DM) has been considered a “Coronary Artery Disease (CAD) equivalent”, that is still controversial, especially in a contemporary population subject to optimized treatment.Objective:We aimed to assess the cardiovascular risk of diabetics by myocardial perfusion scintigraphy (MPS).Methods:Consecutive patients who underwent MPS from 2008 to 2012 were studied. Perfusion scores were calculated, and abnormal MPS was defined as a summed stress score >3. Patients were followed for 3±1 years for all-cause death, which was compared between patients with DM (without known CAD) and patients with known CAD but without DM.Results:Among 3409 patients, 471 (13.8%) were diabetics without known CAD (DM group) and 638 (18.7%) had CAD without diabetes (CAD group). Annualized death rates were not significantly different between DM or CAD patients (0.9vs1.5%, p=0.09). With normal MPS, death rates were 0.7% for DM and 0.6% for CAD (p=0.8). With abnormal MPS, death rates increased similarly in the DM and CAD groups.Conclusions:In diabetic patients without known CAD, the rate of death was not significantly different from patients with prior CAD and without DM. Abnormal MPS increased risk similarly in diabetic patients and in those with CAD. These findings suggest that DM may still be considered a high-risk condition, comparable to known CAD, and effectively stratified by MPS.

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