Relationship between vascular stiffness and stress myocardial perfusion imaging in asymptomatic patients with diabetesReport as inadecuate

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European Journal of Nuclear Medicine and Molecular Imaging

, 38:2050

First Online: 18 August 2011Received: 15 February 2011Accepted: 22 July 2011


PurposeVascular stiffness may potentially be used as a screening tool to identify asymptomatic patients with diabetes with abnormal myocardial perfusion. The purpose of this study was therefore to determine the association between vascular stiffness, measured in term of pulse wave velocity PWV and augmentation index AIx, and abnormal myocardial perfusion imaging MPI in asymptomatic patients with diabetes.

MethodsProspectively, 160 asymptomatic patients with diabetes mean age 51 years, 87 men underwent MPI with adenosine stress. The summed stress score SSS was determined in each patient according to a 17-segment and five-point score. Abnormal MPI SSS ≥3 was classified as moderate SSS 3–7 or severe SSS ≥8 MPI defects. Using applanation tonometry, the carotid–femoral PWV and the radial AIx corrected to 75 beats per minute were determined noninvasively.

ResultsMPI was abnormal in 61 patients 38%, with severe MPI defects in 22 patients 14%. Mean PWV increased with deteriorating MPI from 8.4 ± 2.2 m-s in normal MPI to 9.0 ± 2.2 m-s in moderate MPI defects p = 0.11 and to 11.1 ± 2.5 m-s in severe MPI defects p < 0.01. Likewise, mean AIx increased from 18.4 ± 13.4% to 19.4 ± 10.7% p = 0.66 and to 25.4 ± 9.0% p = 0.03. After adjustment for age and other risk factors, PWV remained a significant predictor of severe MPI defects p = 0.01, OR 1.50, 95% CI 1.11–2.00, whereas AIx was no longer significant p = 0.20.

ConclusionVascular stiffness measured by PWV is associated with severe MPI defects in asymptomatic patients with diabetes.

KeywordsDiabetes mellitus Vascular stiffness Myocardial perfusion imaging Coronary artery disease Dr. Roos and Dr. Djaberi contributed equally to this work as first authors.

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Author: Cornelis J. Roos - Roxana Djaberi - Joanne D. Schuijf - Eelco J. de Koning - Ton J. Rabelink - Jan W. Smit - Alberto 


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