Poster session II
34.23 Significance of quantification of myocardial blood flow by cardiac PET in diabetic patients for the diagnosis of small vessel disease

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Objective

To determine if there is a difference in quantitative myocardial blood flow reserve between diabetic and non-diabetic patients with similar qualitative scan interpretation.

Methods

77 consecutive patients undergoing NH3 rest and stress (adenosine) PET myocardial perfusion imaging (MPI) were studied. Fifteen patients had diabetes mellitus (mean age 62+8; 14 males) and 62 were non-diabetics (mean age 60+11; 45 males). There was no significant difference in Framingham LDL risk score between the groups. NH3 blood flow was measured in nine different regions of the heart using a two compartment model.

Results

Qualitatively 9 out of 15 (60%) of diabetic patients had perfusion defects on MPI and 35 out of 62 (56%) of non-diabetic patients had perfusion defects on MPI (p = NS). There was no difference in summed defect score and reversibility score between the two groups. Quantitatively there was no significant difference in regional or global myocardial blood flow at rest between diabetic and non-diabetic patients (0.65+0.2 ml/g/min vs. 0.77+0.2 ml/g/min; p = NS). At stress, global coronary flow

Conclusion

There is no significant difference in resting myocardial blood flow in diabetic patients compared to non-diabetic patients. However, both global and regional myocardial flow reserve is decreased in diabetic patients compared to non-diabetic patients. This likely reflects small vessel disease or endothelial dysfunction and quantification of myocardial blood flow by cardiac PET may be useful to assess total extent of blood flow limitation.

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