ARYA Atherosclerosis Journal

Risk stratification of diabetic patients with unusual cardiac symptoms using a myocardial perfusion scan

Document Type : Original Article(s)

Authors

Shirin Sarejloo 1
Fatemeh Dehghani 1
Mohammad Reza Hatamnejad 2
Soodeh Jahangiri 2
Tahereh Ghaedian 1
Maryam Salimi 3
Hamed Bazrafshan Drissi 1

1 Al-Zahra Charity Hospital, Department of Cardiology Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

3 Shiraz University of Medical Sciences, Shiraz, Iran

https://doi.org/10.48305/arya.2022.11824.2494
Abstract
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. 
Methods: 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.

Highlights

The PubMed and Google Scholar links for Hamed Bazrafshan.

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Keywords

Diabetes Mellitus
Coronary Artery
Myocardial Perfusion Scan
Atypical Presentation
Atherosclerosis
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ARYA Atherosclerosis Journal
Volume 19, Issue 1
January 2023
Pages 44-52

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