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12.09.2018 | Original Article

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

Zeitschrift:
Journal of Nuclear Cardiology
Autoren:
DNB Dharmender Malik, MD, DNB Bhagwant Rai Mittal, DNB Ashwani Sood, MSc Madan Parmar, MSc Komalpreet Kaur, MD, DM Ajay Bahl
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12350-018-1436-z) contains supplementary material, which is available to authorized users.
The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.

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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Zusatzmaterial
Supplementary material 1 (PPTX 830 kb)
12350_2018_1436_MOESM1_ESM.pptx
Literatur
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