Relationship between vascular stiffness and stress myocardial perfusion imaging in asymptomatic patients with diabetes.

Abstract:

PURPOSE:Vascular stiffness may potentially be used as a screening tool to identify asymptomatic patients with diabetes with abnormal myocardial perfusion. The purpose of this study was therefore to determine the association between vascular stiffness, measured in term of pulse wave velocity (PWV) and augmentation index (AIx), and abnormal myocardial perfusion imaging (MPI) in asymptomatic patients with diabetes. METHODS:Prospectively, 160 asymptomatic patients with diabetes (mean age 51 years, 87 men) underwent MPI with adenosine stress. The summed stress score (SSS) was determined in each patient according to a 17-segment and five-point score. Abnormal MPI (SSS ≥ 3) was classified as moderate (SSS 3-7) or severe (SSS ≥ 8) MPI defects. Using applanation tonometry, the carotid-femoral PWV and the radial AIx corrected to 75 beats per minute were determined noninvasively. RESULTS:MPI was abnormal in 61 patients (38%), with severe MPI defects in 22 patients (14%). Mean PWV increased with deteriorating MPI from 8.4 ± 2.2 m/s in normal MPI to 9.0 ± 2.2 m/s in moderate MPI defects (p = 0.11) and to 11.1 ± 2.5 m/s in severe MPI defects (p < 0.01). Likewise, mean AIx increased from 18.4 ± 13.4% to 19.4 ± 10.7% (p = 0.66) and to 25.4 ± 9.0% (p = 0.03). After adjustment for age and other risk factors, PWV remained a significant predictor of severe MPI defects (p = 0.01, OR 1.50, 95% CI 1.11-2.00), whereas AIx was no longer significant (p = 0.20). CONCLUSION:Vascular stiffness measured by PWV is associated with severe MPI defects in asymptomatic patients with diabetes.

authors

Roos CJ,Djaberi R,Schuijf JD,de Koning EJ,Rabelink TJ,Smit JW,Pereira AM,Al Younis I,van der Hiel B,Scholte AJ,Bax JJ,Jukema JW

doi

10.1007/s00259-011-1894-x

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

2050-7

issue

11

eissn

1619-7070

issn

1619-7089

journal_volume

38

pub_type

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