Cai Xiangyi, Zhang Shuihua, Deng Dabiao, Li Honglin, Guan Xueqing, Fang Jin, Zhou Quan
Medical Imaging Center, First Affiliated Hospital of Jinan University Department of Radiology, Guangdong 999 Brain Hospital, Guangzhou, Guangdong, China.
Medicine (Baltimore). 2018 Feb;97(5):e9762. doi: 10.1097/MD.0000000000009762.
Using computed tomography myocardial perfusion imaging (CTP) to investigate resting myocardial perfusion alterations in uncomplicated type 2 diabetes mellitus (T2DM) patients without obstructive coronary artery disease (CAD).A total of 34 participants with 544 myocardial segments were included prospectively: 17 uncomplicated T2DM patients with no significant coronary artery stenosis on coronary computed tomography angiography and 17 healthy controls. Myocardial perfusion was evaluated by transmural perfusion ratio (TPR). Parameters of cardiac structure and function were measured for cardiac comprehensive assessment. Analyses included descriptive statistics and group comparisons.TPR of segments 5, 7, 9, 10 to 14 were significantly reduced in T2DM group compared with controls (P < .05). When 16 myocardial segments were localized into different areas according to the wall orientations, axial levels of left ventricle and coronary artery territories, respectively, TPR of each area in T2DM group were significantly lower than those in the control group (P < .05). No significant differences were found in cardiac anatomy and function analyses between 2 groups.In uncomplicated T2DM patients without obstructive CAD, myocardial perfusion impairments were present and may develop prior to cardiac morphological and functional abnormalities, which can be early detected by CTP.
使用计算机断层扫描心肌灌注成像(CTP)研究无阻塞性冠状动脉疾病(CAD)的非复杂性2型糖尿病(T2DM)患者静息心肌灌注改变。前瞻性纳入了34名参与者共544个心肌节段:17名非复杂性T2DM患者,其冠状动脉计算机断层扫描血管造影显示无明显冠状动脉狭窄,以及17名健康对照者。通过透壁灌注率(TPR)评估心肌灌注。测量心脏结构和功能参数以进行心脏综合评估。分析包括描述性统计和组间比较。与对照组相比,T2DM组中第5、7、9、10至14节段的TPR显著降低(P<0.05)。当根据壁方向、左心室轴水平和冠状动脉区域将16个心肌节段分别定位到不同区域时,T2DM组各区域的TPR均显著低于对照组(P<0.05)。两组间心脏解剖和功能分析未发现显著差异。在无阻塞性CAD的非复杂性T2DM患者中,存在心肌灌注受损,且可能在心脏形态和功能异常之前就已出现,CTP可早期检测到这种情况。