title: Myocardial perfusion at rest in patients with Diabetes Mellitus Type 1 compared with healthy controls assessed with Multi Detector Computed Tomography.
abstract: OBJECTIVE
  Type 1 diabetes mellitus (T1DM) is associated with an increased risk of ischemic heart disease (IHD). The relative contribution of structural and functional abnormalities of the coronary circulation determining clinically manifested IHD remains unknown. The aim of this study was to assess potential differences in myocardial perfusion at rest and coronary atherosclerosis between asymptomatic T1DM patients and healthy controls.
  
  
  METHODS
  Left ventricular (LV) myocardial perfusion at rest measured as LV myocardial Attenuation Density/LV blood pool Attenuation Density (MyoAD-ratio) and coronary artery atherosclerosis were evaluated with 320-multidetector computed tomography angiography in 57 asymptomatic T1DM patients and 114 sex and age matched controls.
  
  
  RESULTS
  In both groups median age was 53 years (p5,p95: 42,67) and 59.6% were men. Median duration of diabetes in the T1DM group was 35 years (p5,p95: 17,49). Median coronary calcium score was higher in T1DM patients (51 vs. 2, p=0.037) compared with controls. However, a similar frequency of >50% stenosis in one or more coronary arteries was found in T1DM patients and controls (18% vs. 14%, p=0.49). LV myocardial perfusion at rest (MyoAD-ratio) was 18% higher in T1DM patients than controls (0.13 vs. 0.11, p<0.0001). This difference was noted throughout all the LV myocardial segments. In a multiple regression analysis including diabetes, sex, age, cardiovascular risk factors, heart rate, calcium score and coronary stenosis >50%, MyoAD-ratio remained significantly higher in T1DM patients (p=0.0001).
  
  
  CONCLUSIONS
  LV myocardial perfusion at rest is higher in T1DM patients compared with controls independent of coronary atherosclerosis and cardiovascular risk factors.
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: hsz199@alumni.ku.dk.
authors.forename: Christina
authors.initials: C
authors.lastname: Byrne
authors.affiliation: Department of Endocrinology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Tonny
authors.initials: T
authors.lastname: Jensen
authors.affiliation: Department of Endocrinology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Henrik Øder
authors.initials: HØ
authors.lastname: Hjortkjær
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: U M
authors.initials: UM
authors.lastname: Mogensen
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: J T
authors.initials: JT
authors.lastname: Kuhl
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Fuchs
authors.affiliation: Department of Endocrinology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Jannik
authors.initials: J
authors.lastname: Hilsted
authors.affiliation: Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, University of Copenhagen, Denmark; Faculty of Health Sciences, University of Copenhagen, Denmark.
authors.forename: Børge G
authors.initials: BG
authors.lastname: Nordestgaard
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Health Sciences, University of Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Health Sciences, University of Copenhagen, Denmark; Department of Radiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: K F
authors.initials: KF
authors.lastname: Kofoed
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000378:metabolism / Q000503:physiopathology*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: 320-multidetector computed tomography; Imaging; Myocardial perfusion; Type 1 diabetes mellitus