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Cardiovascular imaging in diabetes mellitus

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References

  1. Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, et al. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999-2002. Diabetes Care 2006;29:1263-8.

    Article  PubMed  Google Scholar 

  2. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229-34.

    Article  PubMed  CAS  Google Scholar 

  3. Boudina S, Abel ED. Diabetic cardiomyopathy revisited. Circulation 2007;115:3213-23.

    Article  PubMed  Google Scholar 

  4. Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA 1979;241:2035-8.

    Article  PubMed  CAS  Google Scholar 

  5. MacDonald MR, Petrie MC, Hawkins NM, Petrie JR, Fisher M, McKelvie R, Aguilar D, Krum H, McMurray JJ. Diabetes, left ventricular systolic dysfunction, and chronic heart failure. Eur Heart J 2008;29:1224-40.

    Google Scholar 

  6. Paulus WJ, Tschope C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: A consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007;28:2539-50.

    Article  PubMed  Google Scholar 

  7. Calles-Escandon J, Cipolla M. Diabetes and endothelial dysfunction: A clinical perspective. Endocr Rev 2001;22:36-52.

    Article  PubMed  CAS  Google Scholar 

  8. Kang X, Berman DS, Lewin H, Miranda R, Erel J, Friedman JD, et al. Comparative ability of myocardial perfusion single-photon emission computed tomography to detect coronary artery disease in patients with and without diabetes mellitus. Am Heart J 1999;137:949-57.

    Article  PubMed  CAS  Google Scholar 

  9. Elhendy A, van Domburg RT, Poldermans D, Bax JJ, Nierop PR, Geleijnse ML, et al. Safety and feasibility of dobutamine-atropine stress echocardiography for the diagnosis of coronary artery disease in diabetic patients unable to perform an exercise stress test. Diabetes Care 1998;21:1797-802.

    Article  PubMed  CAS  Google Scholar 

  10. Burgstahler C, Beck T, Reimann A, Kuettner A, Kopp AF, Heuschmid M, et al. Diagnostic accuracy of multislice computed tomography for the detection of coronary artery disease in diabetic patients. J Diabetes Complications 2007;21:69-74.

    Article  PubMed  Google Scholar 

  11. Kang X, Berman DS, Lewin HC, Cohen I, Friedman JD, Germano G, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography in patients with diabetes mellitus. Am Heart J 1999;138:1025-32.

    Article  PubMed  CAS  Google Scholar 

  12. Kamalesh M, Matorin R, Sawada S. Prognostic value of a negative stress echocardiographic study in diabetic patients. Am Heart J 2002;143:163-8.

    Article  PubMed  Google Scholar 

  13. Berman DS, Kang X, Hayes SW, Friedman JD, Cohen I, Abidov A, et al. Adenosine myocardial perfusion single-photon emission computed tomography in women compared with men. Impact of diabetes mellitus on incremental prognostic value and effect on patient management. J Am Coll Cardiol 2003;41:1125-33.

    Article  PubMed  Google Scholar 

  14. Chaowalit N, Arruda AL, McCully RB, Bailey KR, Pellikka PA. Dobutamine stress echocardiography in patients with diabetes mellitus: Enhanced prognostic prediction using a simple risk score. J Am Coll Cardiol 2006;47:1029-36.

    Article  PubMed  Google Scholar 

  15. Hakeem A, Bhatti S, Karmali KN, Dillie KS, Cook JR, Xu J, et al. Renal function and risk stratification of diabetic and nondiabetic patients undergoing evaluation for coronary artery disease. JACC Cardiovasc Imaging 2010;3:734-45.

    Article  PubMed  Google Scholar 

  16. Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2010;56:e50-103.

    Article  PubMed  Google Scholar 

  17. Raggi P, Shaw LJ, Berman DS, Callister TQ. Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol 2004;43:1663-9.

    Article  PubMed  CAS  Google Scholar 

  18. Qu W, Le TT, Azen SP, Xiang M, Wong ND, Doherty TM, et al. Value of coronary artery calcium scanning by computed tomography for predicting coronary heart disease in diabetic subjects. Diabetes Care 2003;26:905-10.

    Article  PubMed  Google Scholar 

  19. Wackers FJ, Young LH, Inzucchi SE, Chyun DA, Davey JA, Barrett EJ, et al. Detection of silent myocardial ischemia in asymptomatic diabetic subjects: The DIAD study. Diabetes Care 2004;27:1954-61.

    Article  PubMed  Google Scholar 

  20. Wackers FJ, Chyun DA, Young LH, Heller GV, Iskandrian AE, Davey JA, et al. Resolution of asymptomatic myocardial ischemia in patients with type 2 diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. Diabetes Care 2007;30:2892-8.

    Article  PubMed  Google Scholar 

  21. Shaw LJ, Berman DS, Maron DJ, Mancini GB, Hayes SW, Hartigan PM, et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: Results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy. Circulation 2008;117:1283-91.

    Article  PubMed  Google Scholar 

  22. Frye RL, August P, Brooks MM, Hardison RM, Kelsey SF, MacGregor JM, et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med 2009;360:2503-15.

    Article  PubMed  CAS  Google Scholar 

  23. Shaw L, Cerqueira MD, Brooks MM, Sansing VV, Beller GA, Pop-Busui P, et al. Comparison of 1-year myocardial perfusions pattern by randomized treatment in patients with diabetes and coronary artery disease and relation to clinical outcomes: Results from the BARI 2D trial. Circulation 2010;122:A12697.

    Google Scholar 

  24. Young LH, Wackers FJ, Chyun DA, Davey JA, Barrett EJ, Taillefer R, et al. Cardiac outcomes after screening for asymptomatic coronary artery disease in patients with type 2 diabetes: The DIAD study. A randomized controlled trial. JAMA 2009;301:1547-55.

    Article  PubMed  CAS  Google Scholar 

  25. Scognamiglio R, Negut C, Ramondo A, Tiengo A, Avogaro A. Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus. J Am Coll Cardiol 2006;47:65-71.

    Article  PubMed  Google Scholar 

  26. Fateh-Moghadam S, Reuter T, Htun P, Plockinger U, Dietz R, Bocksch W. Stressechocardiography for risk stratification of asymptomatic patients with type 2 diabetes mellitus. Int J Cardiol 2009;131:288-90.

    Article  PubMed  Google Scholar 

  27. Nandalur KR, Dwamena BA, Choudhri AF, Nandalur MR, Carlos RC. Diagnostic performance of stress cardiac magnetic resonance imaging in the detection of coronary artery disease: A meta-analysis. J Am Coll Cardiol 2007;50:1343-53.

    Article  PubMed  Google Scholar 

  28. Kwong RY, Sattar H, Wu H, Vorobiof G, Gandla V, Steel K, et al. Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction. Circulation 2008;118:1011-20.

    Article  PubMed  Google Scholar 

  29. Giubbini RM, Dondi M, Mut F, Massardo T, Nusa L, Iskandrian AE. Prevalence of ischemic heart disease in asymptomatic patients with diabetes mellitus in developing countries. J Nucl Med 2010;51:1743.

    Google Scholar 

  30. Hendel RC, Berman DS, Di Carli MF, Heidenreich PA, Henkin RE, Pellikka PA, et al. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. Circulation 2009;119:e561-87.

    Article  PubMed  Google Scholar 

  31. Douglas PS, Khandheria B, Stainback RF, Weissman NJ, Peterson ED, Hendel RC, et al. ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 appropriateness criteria for stress echocardiography: A report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine. J Am Coll Cardiol 2008;51:1127-47.

    Article  PubMed  Google Scholar 

  32. Taylor AJ, Cerqueira M, Hodgson JM, Mark D, Min J, O’Gara P, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol 2010;56:1864-94.

    Article  PubMed  Google Scholar 

  33. Korosoglou G, Humpert PM. Non-invasive diagnostic imaging techniques as a window into the diabetic heart: A review of experimental and clinical data. Exp Clin Endocrinol Diabetes 2007;115:211-20.

    Article  PubMed  CAS  Google Scholar 

  34. Diamant M, Lamb HJ, Groeneveld Y, Endert EL, Smit JW, Bax JJ, et al. Diastolic dysfunction is associated with altered myocardial metabolism in asymptomatic normotensive patients with well-controlled type 2 diabetes mellitus. J Am Coll Cardiol 2003;42:328-35.

    Article  PubMed  CAS  Google Scholar 

  35. Loganathan R, Bilgen M, Al-Hafez B, Alenezy MD, Smirnova IV. Cardiac dysfunction in the diabetic rat: Quantitative evaluation using high resolution magnetic resonance imaging. Cardiovasc Diabetol 2006;5:7.

    Article  PubMed  Google Scholar 

  36. Loganathan R, Bilgen M, Al-Hafez B, Smirnova IV. Characterization of alterations in diabetic myocardial tissue using high resolution MRI. Int J Cardiovasc Imaging 2006;22:81-90.

    Article  PubMed  Google Scholar 

  37. Poornima IG, Parikh P, Shannon RP. Diabetic cardiomyopathy: The search for a unifying hypothesis. Circ Res 2006;98:596-605.

    Article  PubMed  CAS  Google Scholar 

  38. Htay T, Mehta D, Heo J, Iskandrian AE. Left ventricular function in patients with type 2 diabetes mellitus. Am J Cardiol 2005;95:798-801.

    Article  PubMed  Google Scholar 

  39. Chung J, Abraszewski P, Yu X, Liu W, Krainik AJ, Ashford M, et al. Paradoxical increase in ventricular torsion and systolic torsion rate in type I diabetic patients under tight glycemic control. J Am Coll Cardiol 2006;47:384-90.

    Article  PubMed  Google Scholar 

  40. Fonseca CG, Dissanayake AM, Doughty RN, Whalley GA, Gamble GD, Cowan BR, et al. Three-dimensional assessment of left ventricular systolic strain in patients with type 2 diabetes mellitus, diastolic dysfunction, and normal ejection fraction. Am J Cardiol 2004;94:1391-5.

    Article  PubMed  Google Scholar 

  41. Hage FG, Smalheiser S, Zoghbi GJ, Perry GJ, Deierhoi M, Warnock D, et al. Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation. Am J Cardiol 2007;100:1020-5.

    Article  PubMed  Google Scholar 

  42. Fujiwara S, Emoto M, Komatsu M, Motoyama K, Morioka T, Koyama H, et al. Arterial wall thickness is associated with insulin resistance in type 2 diabetic patients. J Atheroscler Thromb 2003;10:246-52.

    Article  PubMed  Google Scholar 

  43. Salomaa V, Riley W, Kark JD, Nardo C, Folsom AR. Non-insulin-dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes. The ARIC Study. Atherosclerosis Risk in Communities Study. Circulation 1995;91:1432-43.

    PubMed  CAS  Google Scholar 

  44. van der Meer RW, Diamant M, Westenberg JJ, Doornbos J, Bax JJ, de Roos A, et al. Magnetic resonance assessment of aortic pulse wave velocity, aortic distensibility, and cardiac function in uncomplicated type 2 diabetes mellitus. J Cardiovasc Magn Reson 2007;9:645-51.

    Article  PubMed  Google Scholar 

  45. Henry RM, Ferreira I, Kostense PJ, Dekker JM, Nijpels G, Heine RJ, et al. Type 2 diabetes is associated with impaired endothelium-dependent, flow-mediated dilation, but impaired glucose metabolism is not; The Hoorn Study. Atherosclerosis 2004;174:49-56.

    Article  PubMed  CAS  Google Scholar 

  46. Maser RE, Mitchell BD, Vinik AI, Freeman R. The association between cardiovascular autonomic neuropathy and mortality in individuals with diabetes: A meta-analysis. Diabetes Care 2003;26:1895-901.

    Article  PubMed  Google Scholar 

  47. Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation 2007;115:387-97.

    Article  PubMed  Google Scholar 

  48. Nagamachi S, Fujita S, Nishii R, Futami S, Tamura S, Mizuta M, et al. Prognostic value of cardiac I-123 metaiodobenzylguanidine imaging in patients with non-insulin-dependent diabetes mellitus. J Nucl Cardiol 2006;13:34-42.

    Article  PubMed  Google Scholar 

  49. Gerson MC, Caldwell JH, Ananthasubramaniam K, Clements IP, Henzlova MJ, Amanullah A, et al. Influence of diabetes mellitus on prognostic utility of imaging of myocardial sympathetic innervation in heart failure patients. Circ Cardiovasc Imaging 2011;4:87-93.

    Article  PubMed  Google Scholar 

  50. Hage FG, Iskandrian AE. Cardiac autonomic denervation in diabetes mellitus. Circ Cardiovasc Imaging 2011;4:79-81.

    Article  PubMed  Google Scholar 

  51. Sacre JW, Franjic B, Jellis CL, Jenkins C, Coombes JS, Marwick TH. Association of cardiac autonomic neuropathy with subclinical myocardial dysfunction in type 2 diabetes. JACC Cardiovasc Imaging 2010;3:1207-15.

    Article  PubMed  Google Scholar 

  52. Di Carli MF, Bianco-Batlles D, Landa ME, Kazmers A, Groehn H, Muzik O, et al. Effects of autonomic neuropathy on coronary blood flow in patients with diabetes mellitus. Circulation 1999;100:813-9.

    PubMed  CAS  Google Scholar 

  53. Yamada T, Yoshitama T, Makino K, Lee T, Saeki F. Heart rate recovery after exercise is a predictor of silent myocardial ischemia in patients with type 2 diabetes. Diabetes Care 2011;34:724-6.

    Article  PubMed  Google Scholar 

  54. Hage FG, Heo J, Franks B, Belardinelli L, Blackburn B, Wang W, et al. Differences in heart rate response to adenosine and regadenoson in patients with and without diabetes mellitus. Am Heart J 2009;157:771-6.

    Article  PubMed  CAS  Google Scholar 

  55. Bravo PE, Hage FG, Woodham RM, Heo J, Iskandrian AE. Heart rate response to adenosine in patients with diabetes mellitus and normal myocardial perfusion imaging. Am J Cardiol 2008;102:1103-6.

    Article  PubMed  CAS  Google Scholar 

  56. Hage FG, Perry G, Heo J, Iskandrian AE. Blunting of the heart rate response to adenosine and regadenoson in relation to hyperglycemia and the metabolic syndrome. Am J Cardiol 2010;105:839-43.

    Article  PubMed  CAS  Google Scholar 

  57. Venkataraman R, Hage FG, Dorfman TA, Heo J, Aqel RA, de Mattos AM, et al. Relation between heart rate response to adenosine and mortality in patients with end-stage renal disease. Am J Cardiol 2009;103:1159-64.

    Article  PubMed  CAS  Google Scholar 

  58. Mathur S, Shah AR, Ahlberg AW, Katten DM, Heller GV. Blunted heart rate response as a predictor of cardiac death in patients undergoing vasodilator stress technetium-99m sestamibi gated SPECT myocardial perfusion imaging. J Nucl Cardiol 2010;17:617-24.

    Article  PubMed  Google Scholar 

  59. Hage FG, Dean P, Bhatia V, Iqbal F, Heo J, Iskandrian AE. The prognostic value of the heart rate response to adenosine in relation to diabetes mellitus and chronic kidney disease. Am Heart J 2011. doi:10.1016/j.ahj.2011.05.014.

  60. Hage FG, Dean P, Iqbal F, Heo J, Iskandrian AE. A blunted heart rate response to regadenoson is an independent prognostic indicator in patients undergoing myocardial perfusion imaging. J Nucl Cardiol 2011. doi:10.1007/s12350-011-9429-1.

  61. Peterson LR, Gropler RJ. Radionuclide imaging of myocardial metabolism. Circ Cardiovasc Imaging 2010;3:211-22.

    Article  PubMed  Google Scholar 

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Correspondence to Fadi G. Hage MD, FACC.

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Hage, F.G., Iskandrian, A.E. Cardiovascular imaging in diabetes mellitus. J. Nucl. Cardiol. 18, 959–965 (2011). https://doi.org/10.1007/s12350-011-9431-7

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