title: Type 2 diabetes mellitus correlates with systolic function during myocardial stress perfusion scanning with Nitrogen-13 ammonia PET.
abstract: The influence of type 2 diabetes mellitus (DM2) on systolic function is partially determined by the coronary vasodilator function, nevertheless, an independent effect is suspected. We evaluated the relationship between DM2 and systolic function considering PET quantitative myocardial perfusion.
  
  
  
  We analyzed 585 patients without a previous myocardial infarction referred to a rest and adenosine stress Nitrogen-13 ammonia PET. A bootstrapped multiple linear regression analysis was performed using DM2, stress myocardial blood flow (sMBF), myocardial perfusion reserve (MPR), and clinical risk factors as predictors and LVEF as the outcome variable; an interaction term was additionally investigated.
  
  
  
  Two hundred and ninety male and 295 female patients (mean age 65.3 ± 9.9 and 67.4 ± 10 years, respectively) were included. 57.1% presented hypertension, 16% smoking, 37.6% hypercholesterolemia, 33.8% family history for CAD, and 15.2% DM2. The mean MPR was 2.13 ± 0.48 and 2.21 ± 0.60, mean sMBF was 2.01 ± 0.51 and 2.15 ± 0.54, and mean LVEF was 63% ± 10.4 and 67% ± 10.1 for diabetics and non-diabetics, respectively. A significant relation was detected for sMBF (B = 5.830 95% CI [3.505, 9.549], P = .001) and DM2 (B = -2.599 95% CI [-5.125, -0.119], P = .03) with LVEF. The interaction (DM2 × sMBF) yielded no significance (P = .512).
  
  
  
  DM2 influences PET-measured systolic function in patients without previous myocardial infarction independently from myocardial perfusion parameters. Our study supports the importance of DM2 as an independent risk factor for deteriorating systolic function.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, Internal Post: EB50, 9700RB, Groningen, The Netherlands. l.e.juarez.orozco@gmail.com.|PET/CT Cyclotron Unit, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico. l.e.juarez.orozco@gmail.com.
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Juárez-Orozco
authors.affiliation: Department of Nuclear Medicine, Medical Center Alkmaar, Alkmaar, The Netherlands.
authors.forename: Friso M
authors.initials: FM
authors.lastname: van der Zant
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, Internal Post: EB50, 9700RB, Groningen, The Netherlands.|Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands.
authors.forename: Riemer H J A
authors.initials: RHJA
authors.lastname: Slart
authors.affiliation: Department of Nuclear Medicine, Medical Center Alkmaar, Alkmaar, The Netherlands.
authors.forename: Sergiy V
authors.initials: SV
authors.lastname: Lazarenko
authors.affiliation: PET/CT Cyclotron Unit, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
authors.forename: Erick
authors.initials: E
authors.lastname: Alexanderson
authors.affiliation: Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Rene A
authors.initials: RA
authors.lastname: Tio
authors.affiliation: Department of Nuclear Medicine, Medical Center Alkmaar, Alkmaar, The Netherlands.
authors.forename: Remco J J
authors.initials: RJJ
authors.lastname: Knol
mesh_terms: D000368:Aged; D003326:Coronary Circulation; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009590:Nitrogen Radioisotopes; D049268:Positron-Emission Tomography / Q000379:methods*; D013599:Systole; D016277:Ventricular Function, Left
chemical_list: D009590:Nitrogen Radioisotopes; C000615247:Nitrogen-13
keywords: LVEF; MPR; PET; diabetes mellitus; myocardial perfusion