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Prognostic value of left ventricular mechanical dyssynchrony indices in long-standing type II diabetes mellitus with normal perfusion and left ventricular systolic functions on SPECT-MPI

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Journal of Nuclear Cardiology Aims and scope

Abstract

Objective

To test whether phase analysis indices from SPECT-MPI for left ventricular mechanical dyssynchrony (LVMD) are predictors of major adverse cardiac events (MACEs) in long-standing diabetes mellitus (DM).

Methods

A total of 136 DM patients with normal perfusion and left ventricular systolic functions were followed up for about two years and divided into two groups according to the presence and the absence of MACEs.

Result

Thirteen (9.5%) patients experienced MACEs during follow-up. Patients experiencing MACEs showed significantly higher phase standard deviation (PSD) and wider phase bandwidth (PBW) than those who did not. Moreover, both PSD and PBW showed significant correlations (r = 0.25 and 0.27; P < 0.05) with duration of DM. Logistic regression analysis revealed significant associations of DM duration, microvascular complications, and LVMD indices for predicting MACEs. Kaplan–Meier event-free survival analysis revealed significantly higher rate of MACEs (Logrank = 10.02; P = 0.001) in patients with high PSD and wide PBW. An overall fit model consisting of high-PSD and wide-PBW group was improved with the addition of microvascular complications (χ2 = 15.9; P = 0.03) and further by addition of DM duration of ≥ 15 years (χ2 = 24.3; P = 0.007) as variables.

Conclusion

LVMD indices are novel prognostic markers in diabetic patients with normal perfusion and left ventricular systolic functions and their increases in magnitudes with DM-duration and in the presence of microvascular complications.

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Abbreviations

DM:

Diabetes mellitus

LVMD:

Left ventricular mechanical dyssynchrony

MACEs:

Major adverse cardiac events

PSD:

Phase standard deviation

PBW:

Phase bandwidth

CAD:

Coronary artery disease

DCM:

Diabetic cardiomyopathy

TDI:

Tissue doppler imaging

LVEF:

Left ventricle ejection fraction

SPECT-MPI:

Single-photon emission computed tomography myocardial perfusion imaging

CRT:

Cardiac resynchronization therapy

LVD:

Left ventricular dyssynchrony

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Disclosures

There is no potential conflict of interest to disclose.

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Authors and Affiliations

  1. Nuclear Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Dharmender Malik DNB, Bhagwant Rai Mittal MD, DNB, Ashwani Sood DNB, Madan Parmar MSc & Komalpreet Kaur MSc

  2. Cardiology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Ajay Bahl MD, DM

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  1. Dharmender Malik DNB
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  2. Bhagwant Rai Mittal MD, DNB
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  3. Ashwani Sood DNB
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  4. Madan Parmar MSc
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  5. Komalpreet Kaur MSc
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  6. Ajay Bahl MD, DM
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Correspondence to Ashwani Sood DNB.

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Malik, D., Mittal, B.R., Sood, A. et al. Prognostic value of left ventricular mechanical dyssynchrony indices in long-standing type II diabetes mellitus with normal perfusion and left ventricular systolic functions on SPECT-MPI. J. Nucl. Cardiol. 27, 1640–1648 (2020). https://doi.org/10.1007/s12350-018-1436-z

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  • DOI: https://doi.org/10.1007/s12350-018-1436-z

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