Comparing left ventricular mechanical dyssynchrony between diabetic and non-diabetic patients with normal gated SPECT MPI

Abstract

Introduction; the aim of this study was to employ phase analysis to diagnose left ventricular mechanical dyssynchrony (LVMD)in asymptomatic patients with diabetes mellitus type 2 and normal perfusion study to prevent diabetic cardiomyopathy.Methods & materials; Ninety-three consecutive patients with known type 2 diabetes and 81 age-and gender-matched patients without diabetes who were candidates for SPECT-MPI were considered as the control group. The presence of LVMD as an indicator of cardiomyopathy-was determined using phase analysis for each scan with quantitative gated SPECT (QGS) and corridor4DM (4DM) software. All outcomes such as phase bandwidth (PBW) and phase standard deviation (PSD) were compared between the two groups.Results; A total of 174 patients were included in the study. There were no statistically signi cant difference regarding demographic factors between the two groups (P>0.05). PBW showed statistically signi cant differences (increased in diabetics) between the control and diabetic patients (P < 0.05).Kruskal Wallis analysis revealed that as the duration of diabetes is prolonged, especially more than 15 years, the probability of LVMD is increased as well (p=0.021).Discussion; Fraction of asymptomatic diabetic patients with normal ejection fraction and gated SPECT MPI-especially those with prolonged diabetes-might have some degrees of LVMD. Phase analysis can detect this which in turn would prevent progress into heart failure.

Association of epicardial fat volume with subclinical myocardial damage in patients with type 2 diabetes mellitus

“…LVSD existed in T2DM patients with normal myocardial perfusion and normal LVEF, which is also known as subclinical myocardial damage and challenging to diagnose early ( 23 , 24 ). Previous studies based on SPECT-MPI have demonstrated that 23–28% of T2DM patients with normal LVEF and normal myocardial perfusion had the presence of LVSD ( 19 , 22 ), which was similar to our findings. A large community-based cohort study found that patients with subclinical myocardial damage have a significantly increased risk of HF and all-cause mortality than those without subclinical myocardial damage ( 25 ).…”

“…Generalized additive model (GAM) and cubic spline smoothing technique were performed to evaluate the association between EFV and LVSD in T2DM patients. Multivariable logistic regression models were produced to assess the association between EFV and LVSD; three models were generated: (I) a univariable model with EFV as a predictor; (II) multivariable-adjusted model 1, adjusted for age and sex; (III) multivariable-adjusted model 2 was constructed based on our team’s interpretation of a broad review of the literature, and adjusted for age, sex, BMI, DM duration, presence of hypertension, active smoking, FBG, HbA1c, and TG ( 19 , 21 , 22 ). Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of EFV for LVSD.…”

Characterization of left ventricular diastolic parameters of gated-single-photon emission computed tomography myocardial perfusion imaging in patients with diabetes and normal myocardial perfusion and systolic function

“…Similar studies comparing diabetes and nondiabetes patients with normal myocardial perfusion and systolic function have focused on other parameters of the G-SPECT MPI. Studies assessing dyssynchrony in patients with diabetes showed no significant difference in dyssynchrony parameters of G-SPECT MPI in diabetes and nondiabetes patients in general, whereas a significant correlation between long-standing diabetes and dyssynchrony has been reported [24,25]. However, a recent study reported a correlation between ES-SI and ED-SI in the presence of diabetes [19].…”