title: Myocardial perfusion single photon emission computed tomography in asymptomatic diabetics.
abstract: BACKGROUND
  Coronary artery disease (CAD) is the most important cause of mortality in diabetic patients. Diabetes mellitus (DM) due to autonomic neuropathy leads to asymptomatic CAD. Hence, it is important to screen the patients with DM for CAD.
  
  
  OBJECTIVE
  To study the prevalence of asymptomatic CAD by Myocardial Perfuision SPECT (Single Photon Emission Computed Tomography) (MPS) in diabetics.
  
  
  METHODS
  This prospective study included 88 asymptomatic patients (58 males and 30 females) of Type 2 DM of more than 5 years duration in the age group of 40-65 years. Risk factors like hypertension, dyslipidemia, smoking, family history of CAD and Body Mass Index > or = 25 kg/sq.m were assessed. All these patients underwent MPS study as two day standard protocol. Thirty eight patients underwent invasive Coronary Angiography (CAG) and stenosis greater than 50% was considered significant.
  
  
  RESULTS
  Abnormal perfusion was detected in 38 (43%) diabetics and 4 (11%) controls. A total of 81 perfusion defects were identified (19 fired and 62 reversible). CAG showed significant coronary stenosis in 26 (68.4%), insignificant in 8 (21%) and no stenosis in 4 (10.6%) patients. A total of 114 coronaries were analysed, significant stenosis in 67 (58.8%) coronaries, 21 (18.4%) had insignificant lesions and 26(22.8%) were normal. In comparison to CAG, MPS had sensitivity of 86.6% and specificity of 51%.
  
  
  CONCLUSIONS
  The Myocardial Perfusion SPECT is a sensitive diagnostic tool to identify ischemia in asymptomatic diabetics. MPS can be used as screening test for risk stratification. It has a prognostic value in predicting the outcome of CAD and can be useful for long-term follow up too.
authors.affiliation: Department of Nuclear Medicine/Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu, India. ismurthy@hotmail.com
authors.forename: K
authors.initials: K
authors.lastname: Harshad
authors.forename: I
authors.initials: I
authors.lastname: Sathyamurthy
authors.forename: G
authors.initials: G
authors.lastname: Ashish
authors.forename: D
authors.initials: D
authors.lastname: Padma
authors.forename: S
authors.initials: S
authors.lastname: Shelley
authors.forename: M
authors.initials: M
authors.lastname: Indirani
authors.forename: K
authors.initials: K
authors.lastname: Subramanian
mesh_terms: D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003627:Data Interpretation, Statistical; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D004280:Dobutamine / Q000008:administration & dosage; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013566:Sympathomimetics / Q000008:administration & dosage; D014055:Tomography, Emission-Computed
chemical_list: D013566:Sympathomimetics; D004280:Dobutamine