Prognostic value of left ventricular mechanical dyssynchrony indices in long-standing type II diabetes mellitus with normal perfusion and left ventricular systolic functions on SPECT-MPI
To test whether phase analysis indices from SPECT-MPI for left ventricular mechanical dyssynchrony (LVMD) are predictors of major adverse cardiac events (MACEs) in long-standing diabetes mellitus (DM).
A total of 136 DM patients with normal perfusion and left ventricular systolic functions were followed up for about two years and divided into two groups according to the presence and the absence of MACEs.
Thirteen (9.5%) patients experienced MACEs during follow-up. Patients experiencing MACEs showed significantly higher phase standard deviation (PSD) and wider phase bandwidth (PBW) than those who did not. Moreover, both PSD and PBW showed significant correlations (r = 0.25 and 0.27; P < 0.05) with duration of DM. Logistic regression analysis revealed significant associations of DM duration, microvascular complications, and LVMD indices for predicting MACEs. Kaplan–Meier event-free survival analysis revealed significantly higher rate of MACEs (Logrank = 10.02; P = 0.001) in patients with high PSD and wide PBW. An overall fit model consisting of high-PSD and wide-PBW group was improved with the addition of microvascular complications (χ2 = 15.9; P = 0.03) and further by addition of DM duration of ≥ 15 years (χ2 = 24.3; P = 0.007) as variables.
LVMD indices are novel prognostic markers in diabetic patients with normal perfusion and left ventricular systolic functions and their increases in magnitudes with DM-duration and in the presence of microvascular complications.
KeywordsDiabetes mellitus SPECT-MPI phase analysis phase standard deviation phase bandwidth LVMD indices
Left ventricular mechanical dyssynchrony
Major adverse cardiac events
Phase standard deviation
Coronary artery disease
Tissue doppler imaging
Left ventricle ejection fraction
Single-photon emission computed tomography myocardial perfusion imaging
Cardiac resynchronization therapy
Left ventricular dyssynchrony
There is no potential conflict of interest to disclose.
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