Long-term survival of patients with ischemic cardiomyopathy and diabetes as compared to those without diabetes undergoing myocardial viability assessment with 18FDG-PET

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Author Info

Christian Pirich Gundula Rendl Johann Altenberger Johannes Holzmannhofer Keinrath Peter Margarida Rodrigues Uta Hoppe Wolfgang Hitzl

Corresponding Author

Christian Pirich
Department of Nuclear Medicine and Endocrinology, Paracelsus Medical University, Müllner Hauptstrasse 48, A-5020 Salzburg, Austria

A B S T R A C T

Objective: 18FDG-PET is considered the most sensitive test to detect hibernating myocardium. We compare the predictive value of 18FDG-PET for long-term survival of patients with ischemic cardiomyopathy and diabetes versus those without diabetes that were referred for 18FDG-PET to assess hibernating myocardium. Patients and methods: 80 patients (24 diabetics) with angiographically documented ischemic cardiomyopathy who underwent myocardial perfusion scintigraphy with 99mTc-tetrofosmin and myocardial viability evaluation by 18FDG PET/CT (after hyperinsulinemic-euglycemic clamp protocol with acipimox) were investigated. Median follow-up after viability testing was 62.4±33.2 months. Results: All patients had impaired left ventricular ejection fraction (mean 32.9±9.3%). Diabetic patients had fewer percent of scar tissue (16.0±12.0) as compared to nondiabetic patients (25.7±18.7) (p<0.01), while the amount of hypoperfused and viable myocardium was not significantly different (14.5±12.6 vs. 9.8±12.0) (p=0.21).12 patients had 1 vessel disease (VD), 15 patients 2 VD, 49 patients 3 VD, and 4 patients diffuse calcification in stenotic coronary arteries. Diabetic patients had significantly more commonly 3 VD than nondiabetic patients (83% vs. 52%, p<0.01). The number of revascularization procedures in diabetic patients and nondiabetic patients was statistically not significantly different (71% vs. 54%, p=0.55). Median survival was 69.3 months (60.1-77.9 months) in nondiabetic patients and 46.5 months (32.7-60.3 months) in diabetic patients (p<0.001). Conclusions: Patients with ischemic cardiomyopathy, impaired LVEF and diabetes exhibited significantly reduced overall survival compared to those without diabetes though having less scared and equal amounts of viable myocardium as indicated by 18FDG-PET.

Article Info

Article Type

Research Article

Publication history

Received: Wed 26, Dec 2018
Accepted: Tue 08, Jan 2019
Published: Sat 23, Feb 2019

Copyright

© 2023 Christian Pirich. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JICOA.2019.01.001