PDF(Pubmed)
Abstract：
BACKGROUND: Autonomic nervous system dysfunction in diabetic patients can result in an atypical presentation of cardiovascular disease that can be missed. We aimed to use single-photon emission computed tomography (SPECT) to assess cardiovascular disease (CAD) in diabetic patients with atypical pain to determine whether the pain above reflects the CAD.
METHODS: Diabetic patients with atypical cardiac symptoms were referred to the SPECT department. Demographic data such as age, gender, diabetes status, and other underlying diseases were gathered. A myocardial perfusion scan was then performed. The results were recorded to evaluate the risk of myocardial ischemia and the degree of coronary artery involvement in a non-invasive manner.
RESULTS: The study included 222 (177 female) subjects with mean ages of 63.01±11.62 and 59.41±9.19 in positive and negative SPECT, respectively. The most common symptoms were atypical chest pain (51.8%), followed by shortness of breath (50.5%), nausea, and syncope (0.9%). Cardiac parameters, such as the summed stress score (SSS), summed rest score (SRS), total perfusion deficit in stress (TPD-s), total perfusion deficit in rest (TPD-r), were significantly higher in the group with coronary artery involvement (P<0.001). However, ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volumes (ESV) parameters were not (P=.0.328, 0.351, and 0.443, respectively).
CONCLUSIONS: The mere presence of diabetes does not necessitate any additional diagnostic tests beyond those required for the general population, and it is possible to follow a diagnostic course similar to that of the general population.
METHODS: Diabetic patients with atypical cardiac symptoms were referred to the SPECT department. Demographic data such as age, gender, diabetes status, and other underlying diseases were gathered. A myocardial perfusion scan was then performed. The results were recorded to evaluate the risk of myocardial ischemia and the degree of coronary artery involvement in a non-invasive manner.
RESULTS: The study included 222 (177 female) subjects with mean ages of 63.01±11.62 and 59.41±9.19 in positive and negative SPECT, respectively. The most common symptoms were atypical chest pain (51.8%), followed by shortness of breath (50.5%), nausea, and syncope (0.9%). Cardiac parameters, such as the summed stress score (SSS), summed rest score (SRS), total perfusion deficit in stress (TPD-s), total perfusion deficit in rest (TPD-r), were significantly higher in the group with coronary artery involvement (P<0.001). However, ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volumes (ESV) parameters were not (P=.0.328, 0.351, and 0.443, respectively).
CONCLUSIONS: The mere presence of diabetes does not necessitate any additional diagnostic tests beyond those required for the general population, and it is possible to follow a diagnostic course similar to that of the general population.
摘要：
背景：糖尿病患者的自主神经系统功能障碍可导致心血管疾病的不典型表现，可被遗漏。我们旨在使用单光子发射计算机断层扫描（SPECT）评估患有非典型疼痛的糖尿病患者的心血管疾病（CAD），以确定上述疼痛是否反映了CAD。
方法：患有非典型心脏症状的糖尿病患者被转诊到SPECT科。人口统计数据，如年龄，性别,糖尿病状态，和其他潜在的疾病被收集。然后进行心肌灌注扫描。记录结果，以无创方式评估心肌缺血的风险和冠状动脉受累程度。
结果：该研究包括222名（177名女性）受试者，在阳性和阴性SPECT中平均年龄为63.01±11.62和59.41±9.19，分别。最常见的症状为不典型胸痛(51.8%),其次是呼吸急促（50.5%），恶心,和晕厥(0.9%)。心脏参数,例如求和压力分数(SSS)，总休息分数(SRS)，应力总灌注不足(TPD-s)，静息总灌注不足(TPD-r)，在冠状动脉受累组中明显高于对照组(P<0.001)。然而,射血分数（EF），舒张末期容积(EDV),和收缩末期容积（ESV）参数没有（分别为P=0.328、0.351和0.443）。
结论：糖尿病的存在不需要任何额外的诊断测试，除了普通人群所需的诊断测试之外，并且可以遵循类似于普通人群的诊断过程。
方法：患有非典型心脏症状的糖尿病患者被转诊到SPECT科。人口统计数据，如年龄，性别,糖尿病状态，和其他潜在的疾病被收集。然后进行心肌灌注扫描。记录结果，以无创方式评估心肌缺血的风险和冠状动脉受累程度。
结果：该研究包括222名（177名女性）受试者，在阳性和阴性SPECT中平均年龄为63.01±11.62和59.41±9.19，分别。最常见的症状为不典型胸痛(51.8%),其次是呼吸急促（50.5%），恶心,和晕厥(0.9%)。心脏参数,例如求和压力分数(SSS)，总休息分数(SRS)，应力总灌注不足(TPD-s)，静息总灌注不足(TPD-r)，在冠状动脉受累组中明显高于对照组(P<0.001)。然而,射血分数（EF），舒张末期容积(EDV),和收缩末期容积（ESV）参数没有（分别为P=0.328、0.351和0.443）。
结论：糖尿病的存在不需要任何额外的诊断测试，除了普通人群所需的诊断测试之外，并且可以遵循类似于普通人群的诊断过程。
