TY - JOUR
AR - JICOA-2019-1-101
TI - Long-term survival of patients with ischemic cardiomyopathy and diabetes as compared to those without diabetes undergoing myocardial viability assessment with 18FDG-PET
AU - Christian, Pirich
AU - Gundula , Rendl
AU - Johann , Altenberger
AU - Johannes , Holzmannhofer
AU - Keinrath, Peter
AU - Margarida , Rodrigues
AU - Uta , Hoppe
AU - Wolfgang , Hitzl
JO - Journal of Integrative Cardiology Open Access
PY - 2019
DA - Sat 23, Feb 2019
SN - 2674-2489
DO - http://dx.doi.org/10.31487/j.JICOA.2019.01.001
UR - https://www.sciencerepository.org/long-term-survival-of-patients-with-ischemic-cardiomyopathy-and-diabetes-as-compared-to-those-without-diabetes-undergoing-myocardial-viability-assessment-with-18fdg-pet_SR-JICOA-2019-1-101 
KW - Coronary disease, Diabetes, 18FDG-PET, survival
AB - 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.