Prognostic Value of Normal Perfusion but Impaired Left Ventricular Function in the Diabetic Heart on Quantitative Gated Myocardial Perfusion SPECT

被引:5
作者
Jeong H.-J. [1 ]
Lee D.S. [2 ]
Lee H.-Y. [2 ]
Choi S.H. [1 ]
Han Y.-H. [1 ]
Chung J.-K. [2 ]
机构
[1] Department of Nuclear Medicine, Research Institute of Clinical Medicine, Biomedical Research Institute of Chonbuk National University Medical School and Hospital, Jeonju, Jeollabuk-do
[2] Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 110-744
基金
新加坡国家研究基金会;
关键词
Diabetes mellitus; Gated myocardial SPECT (Gated SPECT); Prognostic value; Summed systolic thickening score;
D O I
10.1007/s13139-013-0213-9
中图分类号
学科分类号
摘要
Purpose: This study aimed at identifying the predictive parameters on quantitative gated myocardial perfusion single-photon emission computed tomography (QG-SPECT) in diabetic patients with normal perfusion but impaired function. Methods: Among the 533 consecutive diabetic patients, 379 patients with normal perfusion on rest Tl-201/dipyridamole-stress Tc-99m sestamibi Gated SPECT were enrolled. Patients were grouped into those with normal post-stress left ventricular function (Group I) and those with impaired function (EF <50 or impaired regional wall motion, Group II). We investigated cardiac events and cause of death by chart review and telephone interview. Survival analysis and Cox proportional hazard model analysis were performed. Results: Between the Group I and II, cardiac events as well as chest pain symptoms, smoking, diabetic complications were significantly different (P < 0.05). On survival analysis, event free survival rate in Group II was significantly lower than in Group I (P = 0.016). In univariate Cox proportional hazard analysis on overall cardiac event, Group (II over I), diabetic nephropathy, summed motion score (SMS), summed systolic thickening score (STS), numbers of abnormal segmental wall motion and systolic thickening predicted more cardiac events (P < 0.05). Multivariate analysis showed that STS was the only independent predictor cardiac event. Conclusion: The functional parameter, especially summed systolic thickening score on QG-SPECT had prognostic values, despite normal perfusion, in predicting cardiac events in diabetic patients, and QG-SPECT provides clinically useful risk stratification in diabetic patients with normal perfusion. © 2013 Korean Society of Nuclear Medicine.
引用
收藏
页码:151 / 157
页数:6
相关论文
共 28 条
[1]  
Circulation, 100, pp. 1132-1133, (1999)
[2]  
Grundy S.M., Benjamin I.J., Burke G.L., Chait A., Eckel R.H., Howard B.V., Et al., Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association, Circulation, 100, pp. 1134-1146, (1999)
[3]  
Alexander C.M., Landsman P.B., Teutsch S.M., Diabetes mellitus, impaired fasting glucose, atherosclerotic risk factors, and prevalence of coronary heart disease, Am J Cardiol, 86, pp. 897-902, (2000)
[4]  
Taegtmeyer H., McNulty P., Young M.E., Adaptation and maladaptation of the heart in diabetes: part 1 General concept, Circulation, 105, pp. 1727-1733, (2002)
[5]  
Iskandrian A.S., Chae S.C., Heo J., Stanberry C.D., Wasserleben V., Cave V., Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease, J Am Coll Cardiol, 22, pp. 665-670, (1993)
[6]  
Galassi A.R., Azzarelli S., Tomaselli A., Giosofatto R., Ragusa A., Musumeci S., Et al., Incremental prognostic value of technetium-99m-tetrofosmin exercise myocardial perfusion imaging for predicting outcomes in patients with suspected or known coronary artery disease, Am J Cardiol, 88, pp. 101-106, (2001)
[7]  
Sharir T., Germano G., Kavanagh P.B., Lai S., Cohen I., Lewin H.C., Et al., Incremental prognostic value of post-stress left ventricular ejection fraction and volume by gated myocardial perfusion single photon emission computed tomography, Circulation, 100, pp. 1035-1042, (1999)
[8]  
Amanullah A.M., Berman D.S., Erel J., Kiat H., Cohen I., Germano G., Et al., Incremental prognostic value of adenosine myocardial perfusion single-photon emission computed tomography in women with suspected coronary artery disease, Am J Cardiol, 82, pp. 725-730, (1998)
[9]  
Hachamovitch R., Berman D.S., Shaw L.J., Kiat H., Cohen I., Cabico J.A., Et al., Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction, Circulation, 97, pp. 535-543, (1998)
[10]  
Groutars R.G., Verzijlbergen J.F., Muller A.J., Ascoop C.A., Tiel-van Buul M.M., Zwinderman A.H., Et al., Prognostic value and quality of life in patients with normal rest thallium-201/stress technetium 99m-tetrofosmin dual-isotope myocardial SPECT, J Nucl Cardiol, 7, pp. 333-341, (2000)