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Nuklearmedizin 2011; 50(01): 3-8
DOI: 10.3413/nukmed-0318-10-05
Original article
Schattauer GmbH

Myocardial perfusion imaging using technetium-99m sestamibi in asymptomatic diabetic patients

Myokardiale Perfusionsmessung mittels Technetium-99m-Sestamibi bei asymptomatischen Patienten mit Diabetes mellitus
A. Mohagheghie
1   Department of Cardiology, Shariati Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
M. N. Ahmadabadi
1   Department of Cardiology, Shariati Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
D. K. Hedayat
1   Department of Cardiology, Shariati Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
M. R. Pourbehi
2   Bushehr Research Center for Nuclear Medicine, The Persian Gulf Biomedical sciences Institute, Bushehr University of Medical Sciences, Bushehr, Iran
,
M. Assadi
2   Bushehr Research Center for Nuclear Medicine, The Persian Gulf Biomedical sciences Institute, Bushehr University of Medical Sciences, Bushehr, Iran
› Author Affiliations
Further Information

Publication History

received: 22 May 2010

accepted in revised form: 13 October 2010

Publication Date:
28 December 2017 (online)

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Summary

Myocardial perfusion single-photon emission computed tomography (SPECT) has been extensively applied in the clinical assessment of patients with diabetes mellitus. The aim of the present study was to evaluate stress technetium- 99m sestamibi SPECT MPI perfusion in silent myocardial ischemia and its association with some clinical and laboratory parameters in an asymptomatic diabetic population. Patients, material, methods: 83 subjects (age: 57.1 ± 6.9 years) with at least five years history of type 2 diabetes, and no suspected or documented coronary artery disease (CAD) accomplished myocardial perfusion imaging; angiography was also performed in patients with abnormal MPI. Results: MPI results showed that 58 patients had normal myocardial perfusion, while 25 patients showed perfusion defects (23 reversible and 2 fixed) on MPI. 12 out of the 25 (48%) with abnormal MPI findings represented abnormal angiography. We observed that pretest likelihood of CAD (odds ratio 2.32; 95%-CI: 1.05–5.13; p = 0.038) and higher HbA1c level (odds ratio 1.70; 95%-CI, 1.07–2.71; p = 0.02) were independently associated with abnormal MPI. Conclusion: Occult CAD was present on MPI in 1/3 patients with DM without abnormal electro cardiographic findings or evidence of peripheral arterial disease.

Zusammenfassung

Die Myokard-Perfusions-SPECT (Single-Photon- Emissionscomputertomographie) wird bei der klinischen Untersuchung von Patienten mit Diabetes mellitus breit eingesetzt. Ziel dieser Studie war die stumme Myokardischämie anhand der myokardialen Perfusionsmessung (MPI) mittels Belastungs-Technetium-99m- Sestamibi-SPECT, auch in Bezug auf einige klinische und Laborparameter, bei einem Kollektiv asymptomatischer Diabetiker zu untersuchen. Patienten, Material, Methoden: Bei 83 Teilnehmern (Alter 57,1 ± 6,9 Jahre) mit einem seit mindestens fünf Jahren bestehenden Typ- 2-Diabetes ohne Verdacht auf bzw. Nachweis einer koronaren Herzkrankheit (KHK) wurde eine MPI durchgeführt; bei Patienten mit pathologischer MPI erfolgte außerdem eine Koronar- Angiographie. Ergebnisse: Die MPI zeigte bei 58 Patienten eine normale Myokardperfusion, während 25 Patienten Perfusionsdefekte in der MPI aufwiesen (23 reversibel und 2 irreversibel). Bei 12 der 25 Patienten mit pathologischem MPI-Befund (48%) war die Angiographie ebenfalls pathologisch. Die Vortest-Wahrscheinlichkeit für eine KHK (Odds-Ratio 2,32; 95%-CI: 1,05–5,13; p = 0,038) und höhere HbA1c-Spiegel (Odds-Ratio 1,70; 95%-CI: 1,07–2.71; p = 0,02) waren unabhängig voneinander mit einer pathologischen MPI assoziiert. Schlussfolgerung: In der MPI zeigte sich eine okkulte KHK bei 1/3 der Patienten mit Diabetes mellitus ohne pathologische EKG-Befunde oder Hinweise auf peri - phere arterielle Gefäßerkrankung.

Keywords

Myocardial perfusion imaging - asymptomatic diabetic patients - silent ischaemia - coronary artery disease - haemoglobin A1c

Schlüsselwörter

Myokardiale Perfusionsmessung - asymptomatische diabetische Patienten - stumme Ischämie - koronare Herzkrankheit - Hämo globin A1c
 

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