Left ventricular mechanical dyssynchrony assessment in long-standing type II diabetes mellitus patients with normal gated SPECT-MPI

• Published in: Journal of nuclear cardiology Vol. 26; no. 5; pp. 1650 - 1658
• Main Authors: Malik, Dharmender, Mittal, Bhagwant, Sood, Ashwani, Parmar, Madan, Kaur, Gurvinder, Bahl, Ajay
• Format: Journal Article
• Language: English
• Published: Cham Elsevier Inc 01.10.2019; Springer International Publishing; Springer Nature B.V
• Subjects: Aged; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; Cardiology; Case-Control Studies; Diabetes; DIABETES MELLITUS; Diabetes Mellitus, Type 2 - diagnostic imaging; Female; HAZARDS; Heart Ventricles - physiopathology; Humans; Image Processing, Computer-Assisted; Imaging; left ventricular mechanical dyssynchrony; Male; Medicine; Medicine & Public Health; Middle Aged; MULTIVARIATE ANALYSIS; Myocardial Perfusion Imaging; Nuclear Medicine; Original Article; PATIENTS; phase analysis; phase bandwidth; phase standard deviation; PHASE STUDIES; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Regression Analysis; Retrospective Studies; Risk Factors; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY; SPECT-MPI; Treatment Outcome; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Function, Left; PSD; left ventricular mechanical dyssynchrony; LVMD; phase bandwidth; PBW; CRT; Diabetes mellitus; phase analysis; LVEF; DM; DCM; SPECT-MPI; TDI; LVD; phase standard deviation
• ISSN: 1071-3581; 1532-6551; 1532-6551
• DOI: 10.1007/s12350-018-1208-9

Assessment of left ventricular mechanical dyssynchrony (LVMD) using phase analysis of gated SPECT-MPI is well established. However, there is little information about the influence of diabetes mellitus on phase analysis. The present work was to evaluate the LVMD in longstanding type II diabetes mellitus (DM) patients with normal gated SPECT-MPI. Retrospective analysis of 146 (86 type II diabetics for > 5 years’ duration and 60 nondiabetics) consecutive patients with normal gated SPECT-MPI and adequate LVEF was done. Sixty age- and sex-matched nondiabetic served as control. LVMD was determined from the cutoff values (> mean + 2 SD) observed for phase standard deviation (PSD) and phase bandwidth (PBW) from the control subjects. Multivariate logistic regression analysis was applied to assess the correlation between various confounding factors. LVMD was detected in 24 (28%) diabetic patients with the pre-defined cut-off values for PSD (> 10.8) and PBW (> 35.6) derived from the controls. Hyperlipidemia, overweight/obesity, duration of DM and its long-term complications were independently associated with LVMD, with long-term complications being the highest risk factor (OR 28.00; P < .001). The evolution time of the patients with type II diabetes mellitus affects the left ventricular mechanical synchrony.