SPECT holds promise for detecting cardiovascular disease in diabetics
MedWire News: Myocardial fatty acid metabolism imaging is a useful technique for predicting adverse cardiac events in diabetic patients with no prior history of cardiovascular disease (CVD), suggest study findings.
Using single photon emission computed tomography (SPECT) imaging the team found that fatty acid uptake of heart muscle cells was abnormal in those who were at increased risk of cardiac events.
"Diabetes is a serious risk factor for ischemic heart disease," said Kenji Fukushima (Tokyo Women's Medical University, Japan) who presented the results at the Society of Nuclear Medicine Annual Meeting in San Antonio, Texas.
"Most diabetic patients do not exhibit signs of myocardial ischemia and may be on course toward major cardiac events without any red alert. Molecular imaging could potentially provide an effective screening tool for at-risk diabetic patients suspected of having ischemic heart disease," he added.
Fukushima and colleagues recruited 191 diabetic patients, aged 68 years on average and with no history of CVD, to take part in their study.
The participants were injected with I-123 beta-methyl iodophenyl pentadecanoic acid (BMIPP), which allows imaging of the fatty acid uptake of heart muscle cells, before being scanned using TL-201 dual SPECT.
The researchers followed the patients up for 1058 days in total, during which time 13 cardiac deaths or myocardial infarctions occurred ("hard" events) and 25 late coronary interventions, fatal arrhythmias, or heart failure hospitalizations occurred ("soft" events).
Individuals who had noticeable abnormalities of cardiac fatty acid uptake after BMIPP TL-201 dual SPECT imaging were significantly more likely to have a hard or soft event during the follow-up period.
Patients with a mismatch score of 6 or above, calculated by subtracting the BMIPP TL-201 dual SPECT result from bone mineral density dual SPECT result, were found to have a significantly higher rate of total events than those with a lower mismatch score (p<0.0001).
In multivariate analysis, BMIPP TL-201 dual SPECT abnormalities independently predicted soft cardiac events (p=0.001), but not hard events.
This type of imaging may prove to be a useful tool for detecting early signs of CVD in patients with diabetes, concluded Fukushima.
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By Helen Albert