The Role of Myocardial Perfusion Imaging in Patients with Diabetes Mellitus

Diabetes mellitus is a complex pathology with increasing incidence, associated with an increased risk of coronary heart disease. Myocardial perfusion imaging (MPI) is an important diagnostic tool for the evaluation of coronary artery disease (CAD), with a high prognostic value.

Objective. The aim of this study was to evaluate the role of stress-rest MPI in the assessment of patients with DM and suspected or confirmed CAD.

Method. We performed a retrospective analysis of 128 patients who underwent stress-rest MPI in our department, all of them with coronary angiography (CA) available. All patients underwent stress rest myocardial perfusion SPECT using a 1-day or 2-day protocol. The radiopharmaceuticals used were 99m-Tc-MIBI or tetrofosmin. The study was performed with a gated protocol SPECT, synchronous with the ECG, using a dual-head gamma camera. Patients were divided in 4 subgroups based on the presence of DM and of significant CA changes.

Results. In the group of patients with significant coronary disease on CA and previously diagnosed DM, number of perfusion defects on the stress-rest MPI were higher and also the presence of systolic disfunction and the severity of defects. Our results support the idea that the severity and extent of myocardial perfusion defects are greater in diabetic patients than in non-diabetic patients.

Conclusions. We can consider myocardial perfusion SPECT with 99mTc-labeled agents as a feasible method for the diagnosis and evaluation of CAD and for the management of diabetic patients.