Nuclear Medicine Department, Nuclear Medicine and Molecular Imaging Research Center.
Nuclear Medicine Department, Namazi Hospital.
Nucl Med Commun. 2023 Sep 1;44(9):788-794. doi: 10.1097/MNM.0000000000001721. Epub 2023 Jun 19.
Diabetic cardiomyopathy is defined as an independent entity with a specified pathological progression from diastolic dysfunction with preserved ejection fraction to overt heart failure. Myocardial perfusion imaging (MPI) with gated-single-photon emission computed tomography (G-SPECT) has been introduced as a feasible tool to evaluate left ventricular (LV) diastolic function. The aim of this study was to investigate the characteristics of diastolic parameters derived from G-SPECT MPI in diabetic patients compared to patients at very low risk of coronary artery disease (CAD) and with no other CAD risk factors.
This cross-sectional study was performed on patients referred to the nuclear medicine department for G-SPECT MPI. Demographic and clinical data, as well as medical history, were extracted from a digital registry system including 4447 patients. Then, two matched groups of patients with only diabetes as cardiac risk factor ( n = 126) and those without any identifiable CAD risk factors ( n = 126) were selected. Diastolic parameters of MPI, including peak filling rate, time to peak filling rate, mean filling rate at the first third of diastole and second peak filling rate, were derived using quantitative software for eligible cases.
The mean age of the diabetic and nondiabetic groups was 57.1 ± 14.9 and 56.7 ± 10.6 years, respectively ( P = 0.823). Comparison of quantitative SPECT MPI parameters between the two groups showed a statistically significant difference only in total perfusion deficit scores, whereas none of the functional parameters, including diastolic and dyssynchrony indices and the shape index, were significantly different. There were also no significant differences in diastolic function parameters between diabetes and nondiabetes patients in the age and gender subgroups.
Based on the G-SPECT MPI findings, there is a comparable prevalence of diastolic dysfunction in patients with only diabetes as a cardiovascular risk factor and low-risk patients with no cardiovascular risk factors in the setting of normal myocardial perfusion and systolic function.
糖尿病性心肌病定义为一种独立实体，具有特定的病理进展，从舒张功能障碍伴射血分数保留到明显心力衰竭。门控单光子发射计算机断层扫描（G-SPECT）心肌灌注成像（MPI）已被引入作为评估左心室（LV）舒张功能的可行工具。本研究旨在研究与极低冠状动脉疾病（CAD）风险且无其他 CAD 危险因素的患者相比，糖尿病患者的 G-SPECT MPI 衍生舒张参数的特征。
这项横断面研究是在核医学科进行 G-SPECT MPI 的患者中进行的。从包括 4447 例患者的数字登记系统中提取人口统计学和临床数据以及病史。然后，选择仅患有糖尿病作为心脏危险因素（n = 126）和无任何可识别 CAD 危险因素的患者（n = 126）的两组匹配患者。使用定量软件为合格病例得出 MPI 的舒张参数，包括峰值充盈率、充盈率达峰时间、舒张早期三分之一的平均充盈率和第二峰值充盈率。
糖尿病组和非糖尿病组的平均年龄分别为 57.1±14.9 岁和 56.7±10.6 岁（P = 0.823）。两组之间的定量 SPECT MPI 参数比较仅在总灌注缺损评分方面存在统计学显著差异，而舒张和不同步指数以及形状指数等功能参数均无显著差异。在年龄和性别亚组中，糖尿病和非糖尿病患者的舒张功能参数也无显著差异。
根据 G-SPECT MPI 的发现，在正常心肌灌注和收缩功能的情况下，仅患有糖尿病作为心血管危险因素的患者和无心血管危险因素的低危患者的舒张功能障碍的患病率相当。
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