Tehran University of Medical Sciences
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Davood Beiki

The myocardial perfusion scintigraphy in asymptomatic diabetic patients

Authors: Salehi Y, Fard-Esfahani A, Fallahi B, Aghahosseini F, Beiki D, Emami-Ardekani A, Fard-Esfahani P, Ansari M, Eftekhari M,
Keywords: Asymptomatic ischemia; Diabetes mellitus; Myocardial perfusion scintigraphy; Gated SPECT
Iran J Nucl Med, Vol.23, No.1, 2015,Page:27-35

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.