Article Figures & Data
Figures
- FIGURE 1.
Examples of images obtained with DISA 99mTc-tetrofosmin/18F-FDG SPECT after oral administration of acipimox. Baseline 99mTc-tetrofosmin (A) and 18F-FDG (B) vertical long-axis images of patient with diabetes mellitus show perfusion defect in inferior region, with relatively preserved 18F-FDG uptake (mismatch pattern) indicating myocardial viability. Baseline 99mTc-tetrofosmin (C) and 18F-FDG (D) vertical long-axis images of patient without diabetes mellitus show large perfusion defect in apical region with absent 18F-FDG uptake (match pattern), which indicates absence of myocardial viability.
- FIGURE 2.
Bar graph illustrating number of dysfunctional segments and number of viable segments, which were comparable in patients with and in patients without diabetes mellitus (neither is statistically significant). Values are expressed as mean ± SD. DM = diabetes mellitus; + = present; − = absent.
- FIGURE 3.
Bar graph illustrating sensitivities and specificities of 18F-FDG SPECT for prediction of improvement of LVEF after coronary revascularization. Presence of substantial amount of viable tissue (≥4 viable segments) had good sensitivity and specificity for prediction of improvement in LVEF, which was comparable in patients with and without diabetes (neither is statistically significant). DM = diabetes mellitus; + = present; − = absent.
Tables
Characteristic Diabetes (n = 34) No diabetes (n = 96) P Men/women 25 (74)/9 (26) 86 (90)/10 (10) <0.05 Age (y) 62 ± 9 60 ± 9 NS CCS angina class 2.5 ± 0.9 2.2 ± 1.0 NS NYHA functional class 2.7 ± 1.1 2.6 ± 1.1 NS Previous myocardial infarction 32 (94) 91 (95) NS Q wave myocardial infarction 26 (76) 74 (77) NS Anterior myocardial infarction 17 (50) 48 (50) NS Family history of coronary disease 20 (59) 58 (60) NS Hypercholesterolemia 16 (47) 41 (43) NS Smoking, current/prior 9 (26)/15 (44) 34 (35)/37 (39) NS Systemic hypertension 24 (71) 69 (72) NS Stenosed coronary arteries 2.6 ± 0.7 2.5 ± 0.6 NS LVEF (%) 31 ± 10 33 ± 10 NS Baseline plasma glucose (mmol/L) 11 ± 3 5 ± 0.8 <0.01 Medical therapy Insulin 12 (35) Oral antidiabetic medication 27 (79) ACE inhibitors 25 (74) 62 (65) NS Aspirin/anticoagulation 27 (79) 89 (93) NS β-Blockers 16 (44) 65 (68) NS Digoxin 8 (24) 20 (21) NS Diuretics 22 (65) 38 (40) NS Nitrates 27 (79) 73 (76) NS Statins 15 (44) 50 (52) NS Data are mean ± SD or number of patients, with percentages in parentheses. ACE = angiotensin-converting enzyme; CCS = Canadian Cardiovascular Society; NS = not statistically significant; NYHA = New York Heart Association.
- TABLE 2
Functional Outcome in Patients With and Without Diabetes Mellitus According to Presence or Absence of Substantial Amount of Myocardial Viability on 18F-FDG SPECT
Patient group Clinical parameter Before coronary revascularization After coronary revascularization P Diabetes + viability + (n = 11) CCS score 2.7 ± 0.6 1.1 ± 0.3 <0.0001 NYHA class 2.8 ± 1.0 2.1 ± 0.5 <0.05 LVEF 27 ± 9 31 ± 9 <0.05 Diabetes + viability − (n = 18) CCS score 2.3 ± 0.9 1.4 ± 0.5 0.005 NYHA class 2.9 ± 1.0 2.8 ± 0.7 NS LVEF 35 ± 10 35 ± 9 NS Diabetes − viability + (n = 40) CCS score 2.1 ± 1.1 1.4 ± 0.5 <0.005 NYHA class 2.8 ± 1.0 2.1 ± 0.9 <0.005 LVEF 32 ± 10 35 ± 12 0.01 Diabetes − viability − (n = 40) CCS score 2.2 ± 1.0 1.4 ± 0.5 <0.0001 NYHA class 2.2 ± 1.0 2.1 ± 0.9 NS LVEF 37 ± 10 38 ± 9 NS Data are mean ± SD. CCS = Canadian Cardiovascular Society; NS = not statistically significant; NYHA = New York Heart Association; + = present; − = absent. A substantial amount of myocardial viability on 18F-FDG SPECT was defined as presence of ≥4 dysfunctional but viable segments.
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