Changes in ischaemia as assessed with single-photon emission computed tomography myocardial perfusion imaging in high-risk patients with diabetes without cardiac symptoms: relation with coronary atherosclerosis on computed tomography coronary angiography

Michiel A de Graaf, Cornelis J Roos, Josanne M Mansveld, Petra Dibbets-Schneider, Lucia J Kroft, J Wouter Jukema, Edward P Ficaro, Jeroen J Bax, Arthur J Scholte, Aan-Vinay Kharagjitsing

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3 Citations (Scopus)

Abstract

AIMS: The study aims (i) to evaluate changes in myocardial ischaemia on single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) after 2 years in a cohort of high-risk patients with diabetes without cardiac symptoms or known coronary artery disease (CAD) and (ii) to assess the value of baseline computed tomography coronary angiography (CTA)-derived coronary atherosclerosis parameters to predict changes in myocardial ischaemia.

METHODS AND RESULTS: The population consisted of 100 high-risk patients with diabetes without cardiac symptoms referred for cardiovascular risk stratification. All patients underwent coronary artery calcium (CAC) scoring, CTA, and SPECT MPI. After 2 years of follow-up, SPECT MPI was repeated to evaluate potential progression of ischaemia.In total, 20% of patients presented with ischaemia at baseline. Of these 20 patients, 7 (35%) still had ischaemia at follow-up, whereas 13 (65%) showed resolution and 4 (20%) showed progression of ischaemia at follow-up. Of the 80 patients without ischaemia at baseline, 65 (81%) had a normal MPI at follow-up and 15 patients (19%) presented with new ischaemia. There were no significant differences in the CAC score or the extent, severity, and composition of CAD on CTA between patients with and without ischaemia at baseline. Similarly, no differences could be demonstrated between patients with and without ischaemia at follow-up or between patients with and without progression of ischaemia.

CONCLUSION: The rate of progression of ischaemia in high-risk patients with diabetes without cardiac symptoms is limited. Few patients presented with new ischaemia, whereas some patients showed resolution of ischaemia. Atherosclerosis parameters on CTA were not predictive of new-onset ischaemia or progression of ischaemia.

Original languageEnglish
Pages (from-to)863-670
Number of pages8
JournalEuropean Heart Journal - Cardiovascular Imaging
Volume16
Issue number8
DOIs
Publication statusPublished - Aug 2015

Keywords

  • Cardiac-Gated Imaging Techniques
  • Coronary Artery Disease
  • Diabetes Complications
  • Disease Progression
  • Electrocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia
  • Myocardial Perfusion Imaging
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiopharmaceuticals
  • Retrospective Studies
  • Risk Factors
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon
  • Tomography, X-Ray Computed
  • Journal Article
  • Research Support, Non-U.S. Gov't

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