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Cardiac tests in asymptomatic type 2 diabetics.
Abdulnabi T Al-Attar1, Suad A Mahussain, S Sadanandan
1Diabetology Unit, Al-Amiri Hospital, Ministry of Health, Kuwait. Abdul_2345@yahoo.com
Summary
The cardiac exercise tolerance test (ETT) is most effective for detecting silent myocardial ischemia in asymptomatic type 2 diabetes mellitus patients. Echocardiography aids in equivocal ETT findings, revealing a high prevalence of ischemia.
Area of Science:
- Cardiology
- Diabetology
- Diagnostic Imaging
Background:
- Type 2 diabetes mellitus is associated with an increased risk of coronary heart disease.
- Asymptomatic patients with type 2 diabetes may have silent myocardial ischemia.
- Noninvasive diagnostic procedures are crucial for early detection.
Purpose of the Study:
- To evaluate noninvasive methods for detecting myocardial ischemia in asymptomatic type 2 diabetes patients.
- To assess the relationship between myocardial ischemia and other clinical factors.
Main Methods:
- 42 asymptomatic type 2 diabetes patients (aged 41-72) underwent evaluation.
- Procedures included exercise tolerance test (ETT), ECG, echocardiography, and myocardial perfusion scan.
- Technetium-99m tetrofosmin was used for perfusion scans.
Main Results:
- Exercise tolerance test (ETT) detected ischemia in 26.2% of patients.
- Echocardiography revealed diastolic dysfunction in 21.4%.
- Older age (>57) and microalbuminuria/diastolic dysfunction correlated with ischemic ETT.
Conclusions:
- Cardiac ETT is the most effective method for detecting myocardial ischemia in this population.
- Echocardiography is recommended for equivocal ETT results.
- A high prevalence of myocardial ischemia was observed in asymptomatic type 2 diabetes patients.