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Updated: Jun 23, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Risk stratification of diabetic patients with unusual cardiac symptoms using a myocardial perfusion scan
Shirin Sarejloo1, Fatemeh Dehghani1, Mohammad Reza Hatamnejad2
1Al-Zahra Charity Hospital, Department of Cardiology Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Diabetic patients with atypical chest pain can have cardiovascular disease (CAD) detected using single-photon emission computed tomography (SPECT). SPECT effectively identifies coronary artery involvement, guiding diagnosis similarly to the general population.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diabetology
Background:
- Diabetic autonomic neuropathy can mask cardiovascular disease (CAD) symptoms.
- Atypical presentations of CAD in diabetic patients may be overlooked.
- Single-photon emission computed tomography (SPECT) can assess cardiac function.
Purpose of the Study:
- To evaluate cardiovascular disease (CAD) in diabetic patients presenting with atypical pain.
- To determine if atypical pain in diabetics reflects underlying CAD using SPECT.
- To assess the utility of SPECT in diagnosing CAD in this population.
Main Methods:
- Diabetic patients with atypical cardiac symptoms underwent SPECT myocardial perfusion scans.
- Demographic and clinical data were collected.
- SPECT results were analyzed to assess myocardial ischemia and coronary artery involvement.
Main Results:
- 222 patients (177 female) were included.
- Atypical chest pain (51.8%) and shortness of breath (50.5%) were most common symptoms.
- SPECT parameters (SSS, SRS, TPD-s, TPD-r) were significantly higher in patients with coronary artery involvement (P<0.001).
Conclusions:
- Diabetes alone does not require additional diagnostic tests for CAD beyond general population guidelines.
- Diagnostic approaches for CAD in diabetic patients can mirror those for the general population.
- SPECT is a valuable tool for assessing CAD in diabetic patients with atypical symptoms.
Background:
Autonomic nervous system dysfunction in diabetic patients can result in an atypical presentation of cardiovascular disease that can be missed. We aimed to use single-photon emission computed tomography (SPECT) to assess cardiovascular disease (CAD) in diabetic patients with atypical pain to determine whether the pain above reflects the CAD.
Method:
Diabetic patients with atypical cardiac symptoms were referred to the SPECT department. Demographic data such as age, gender, diabetes status, and other underlying diseases were gathered. A myocardial perfusion scan was then performed. The results were recorded to evaluate the risk of myocardial ischemia and the degree of coronary artery involvement in a non-invasive manner.
Results:
The study included 222 (177 female) subjects with mean ages of 63.01±11.62 and 59.41±9.19 in positive and negative SPECT, respectively. The most common symptoms were atypical chest pain (51.8%), followed by shortness of breath (50.5%), nausea, and syncope (0.9%). Cardiac parameters, such as the summed stress score (SSS), summed rest score (SRS), total perfusion deficit in stress (TPD-s), total perfusion deficit in rest (TPD-r), were significantly higher in the group with coronary artery involvement (P<0.001). However, ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volumes (ESV) parameters were not (P=.0.328, 0.351, and 0.443, respectively).
Conclusions:
The mere presence of diabetes does not necessitate any additional diagnostic tests beyond those required for the general population, and it is possible to follow a diagnostic course similar to that of the general population.
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