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P3.3 Cardiac 82RB-PET/CT Reveals Microvascular Dysfunction In Asymptomatic Patients with Type 2 Diabetes

Abstract

Aims

Coronary flow reserve (CFR) and coronary calcium score (CCS) represent different aspects of atherosclerosis. We examined the prevalence and predictors of reduced CFR and high CCS in type 2 diabetes (T2DM) patients free of overt cardiovascular disease compared to non-diabetic controls.

Methods

Cross-sectional study of 60 T2DM patients stratified by normoalbuminuria (<30mg/24h) (n = 30; age (mean±SD) 60.9±10.1 years; 40% women) and albuminuria (>30mg/24h) (n = 30; 65.6±4.8 years; 27% women) randomly selected from our outpatient clinic and 30 non-diabetic controls (59.8±9.9 years; 40% women) undergoing cardiac 82Rb PET/CT.

Results

In controls, normoalbuminuric, and albuminuric patients CFR was 3.0±0.8, 2.6±0.8, and 2.0±0.5 (P<0.001); frequency of reduced CFR (<2.5) was 16.7, 40.0, and 83.3% (P<0.001); and CCS (median[IQR]) was 0 [0–81], 36[1–325], and 370[152–1025] (P<0.001), respectively. After comprehensive adjustment, CFR remained significant higher (P = 0.023) and CCS significant lower (P = 0.020) in normoalbuminuric vs. albuminuric patients. The univariate association between CFR and CCS was significant in control subjects (R2 = 0.23; P = 0.007), but not in normoalbuminuric or albuminuric patients (R2≤0.10; P≥0.09). However, after adjustment lower CFR was related to higher CCS, UAER, age, heart rate, lower HbA1C, and male gender (P≤0.047) in albuminuric patients; and to female gender (P = 0.024) in normoalbuminuric patients. Higher CCS was related to lower CFR and UAER (P≤0.048) in albuminuric patients; and to higher HbA1C in controls (P = 0.033).

Conclusion

T2DM patients free of overt cardiovascular disease had a high prevalence of coronary microvascular dysfunction, especially with concomitant albuminuria. This was not explained by elevated CCS. Prospective studies are needed to show the prognostic significance.

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Hansen, T., Scholten, B., Hasbak, P. et al. P3.3 Cardiac 82RB-PET/CT Reveals Microvascular Dysfunction In Asymptomatic Patients with Type 2 Diabetes. Artery Res 8, 137 (2014). https://doi.org/10.1016/j.artres.2014.09.114

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.114