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Abnormal response to inotropic stimulation in young asymptomatic type I diabetic patients demonstrated by serial gated myocardial perfusion SPECT imaging

par Weytjens, Caroline;Cosyns, Bernard ;Van Camp, Guy;Daniels, Cathy;Spincemaille, K.;Dupont, Alain;Franken, Philippe
Référence European journal of nuclear medicine and molecular imaging, 32, 11, page (1317-1323)
Publication Publié, 2005-11

Article révisé par les pairs

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Résumé :

Purpose: In subjects without underlying cardiac disease dobutamine is known to enhance systolic LV function and LV relaxation. As end-systolic (ES) and end-diastolic (ED) volumes (V) can be derived from gated SPECT we intent to study these volumes and their response to dobutamine in order to have a better understanding of the mechanism by which stroke volume (SV) increases during dobutamine infusion. We intent to do this in normal controls and in young diabetic subjects. Methods: After injection of sestamibi, serial gated SPECT were obtained at baseline, and during low doses of dobutamine infusion in 12 asymptomatic type I diabetic patients, and in 12 age matched controls. LV EDV, ESV, SV and EF were calculated with the QGS program. Results: Gated SPECT showed comparable LV EF and SV in both groups at rest. There was a significant increase in LVEF and SV during dobutamine infusion but in the diabetic patients the increase in SV was due to a decrease in ESV from 25±5 to 20±6 ml/m2 (p=0.002) and no change in EDV. In normal controls, the increase in EF was due to an increase in EDV from 69±10 to 73±12 ml/m2 (p=0.002) with no significant change in ESV. Conclusion: These data confirm the presence of subclinical abnormalities of diastolic function in asymptomatic type I diabetic patients and show differences in adaptation to inotropic stimulation in order to preserve the increase in stroke volume and LV ejection fraction. © Springer-Verlag 2005.