Author + information
- Kai Yi Wua,b,
- Nicholas Timmermana,b,
- Rachel McPhedrana,b,
- Rob Beanlandsa,b,
- Robert deKempa,b and
- Aun-Yeong Chonga,b
Background: Diabetes mellitus (DM) is associated with diffuse atherosclerosis and microvascular dysfunction which may impact measurement of flow and revascularization therapies. The impact of diabetes-related microvascular dysfunction in the presence of epicardial disease is not well known. We sought to determine if myocardial flow reserve (MFR) by positron emission tomography (PET) is reduced in patients with DM across the CAD spectrum.
Methods: 252 consecutive patients (63.9 ± 10.6 years, 181 males, 101 DM) who had both 82Rb PET and invasive coronary angiography within 6 months between July 2012 and April 2016 were included. MFR was calculated for each vessel territory (LAD, LCX, and RCA). To account for the effect of multiple and diffuse epicardial lesions, vessel segments with stenoses >50% were assigned SYNTAX scores multiplied by the % stenosis, and summed to generate territory-specific SYNTAX-weighted Scores (SWS). Multiple linear regression was used to evaluate the relationship between territory-specific MFR and SWS and DM status. SWS>0 were divided into tertiles. Student's t-tests with Bonferroni adjustment were used for comparisons.
Results: Among 756 vascular territories, comparing to those without DM, MFR was reduced by 0.26 (∼15%) in those with DM (p<0.001), and decreased by 0.1 for each 100-point increase in the SWS. Compared to no DM, in patients with DM, MFR was decreased at SWS = 111 to 985 (p< 0.002).
Conclusions: DM is associated with reduced MFR after adjusting for epicardial stenosis.
Moderated Poster Contributions
Non Invasive Imaging Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 10:30 a.m.-10:40 a.m.
Session Title: Noninvasive Assessment of Coronary Flow Reserve: Clinical Implications
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1136M-07
- 2017 American College of Cardiology Foundation