Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging

Georgios I. Papaioannou; Christos Kasapis; Richard L. Seip; Neil J. Grey; Deborah Katten; Frans J.Th Wackers; Silvio E. Inzucchi; Samuel Engel; Amy Taylor; Lawrence H. Young; Deborah A. Chyun; Janice A. Davey; Ami E. Iskandrian; Robert E. Ratner; Evelyn C. Robinson; Stella Carolan; Gary V. Heller

doi:10.1016/j.nuclcard.2006.01.022

Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging

Georgios I. Papaioannou, Christos Kasapis, Richard L. Seip, Neil J. Grey, Deborah Katten, Frans J.Th Wackers, Silvio E. Inzucchi, Samuel Engel, Amy Taylor, Lawrence H. Young, Deborah A. Chyun, Janice A. Davey, Ami E. Iskandrian, Robert E. Ratner, Evelyn C. Robinson, Stella Carolan, Gary V. Heller

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Abstract

Background: Endothelial dysfunction precedes overt atherosclerosis and is present in patients with type 2 diabetes mellitus (T2DM). Myocardial perfusion imaging (MPI) is an effective method of detection of coronary artery disease (CAD); however, the relationship between endothelial function and MPI in asymptomatic patients with T2DM has not been examined. Methods and Results: This study used a subset of the population from the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. Endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation (EIV) were measured by use of brachial artery ultrasonography in 75 asymptomatic patients with T2DM (56 men; mean age, 58.6 ± 6.4 years; mean duration of diabetes, 8.4 ± 7.5 years) who underwent adenosine MPI. Of the patients, 15 (20%) had evidence of relative ischemia (MPI⁺) whereas 60 (80%) had a normal study (MPI^-). Both EDV (3.5% ± 3.7% vs 4.5% ± 6.6%, P = not significant) and EIV (15.1% ± 7.5% vs 16.8% ± 8.4%, P = not significant) were similar in the 2 groups. On the basis of a receiver-operator analysis, an EDV response of 8% was selected as a cut point, with a negative predictive value of 93% (13/14 subjects with EDV ≥8% were MPI^-). Conclusions: Endothelial function in asymptomatic patients with T2DM is not associated with the presence of relative myocardial ischemia by MPI; however, an EDV of 8% or greater has a high negative predictive value for the exclusion of CAD.

Original language	English (US)
Pages (from-to)	362-368
Number of pages	7
Journal	Journal of Nuclear Cardiology
Volume	13
Issue number	3
DOIs	https://doi.org/10.1016/j.nuclcard.2006.01.022
State	Published - Jun 2006

Keywords

Endothelial function
myocardial perfusion imaging
type 2 diabetes mellitus

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1016/j.nuclcard.2006.01.022

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Papaioannou, G. I., Kasapis, C., Seip, R. L., Grey, N. J., Katten, D., Wackers, F. J. T., Inzucchi, S. E., Engel, S., Taylor, A., Young, L. H., Chyun, D. A., Davey, J. A., Iskandrian, A. E., Ratner, R. E., Robinson, E. C., Carolan, S., & Heller, G. V. (2006). Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging. Journal of Nuclear Cardiology, 13(3), 362-368. https://doi.org/10.1016/j.nuclcard.2006.01.022

Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging. / Papaioannou, Georgios I.; Kasapis, Christos; Seip, Richard L. et al.
In: Journal of Nuclear Cardiology, Vol. 13, No. 3, 06.2006, p. 362-368.

Research output: Contribution to journal › Article › peer-review

Papaioannou, GI, Kasapis, C, Seip, RL, Grey, NJ, Katten, D, Wackers, FJT, Inzucchi, SE, Engel, S, Taylor, A, Young, LH, Chyun, DA, Davey, JA, Iskandrian, AE, Ratner, RE, Robinson, EC, Carolan, S & Heller, GV 2006, 'Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging', Journal of Nuclear Cardiology, vol. 13, no. 3, pp. 362-368. https://doi.org/10.1016/j.nuclcard.2006.01.022

@article{75f536761c0648e2be90ab4109e40d2a,

title = "Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging",

abstract = "Background: Endothelial dysfunction precedes overt atherosclerosis and is present in patients with type 2 diabetes mellitus (T2DM). Myocardial perfusion imaging (MPI) is an effective method of detection of coronary artery disease (CAD); however, the relationship between endothelial function and MPI in asymptomatic patients with T2DM has not been examined. Methods and Results: This study used a subset of the population from the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. Endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation (EIV) were measured by use of brachial artery ultrasonography in 75 asymptomatic patients with T2DM (56 men; mean age, 58.6 ± 6.4 years; mean duration of diabetes, 8.4 ± 7.5 years) who underwent adenosine MPI. Of the patients, 15 (20%) had evidence of relative ischemia (MPI+) whereas 60 (80%) had a normal study (MPI-). Both EDV (3.5% ± 3.7% vs 4.5% ± 6.6%, P = not significant) and EIV (15.1% ± 7.5% vs 16.8% ± 8.4%, P = not significant) were similar in the 2 groups. On the basis of a receiver-operator analysis, an EDV response of 8% was selected as a cut point, with a negative predictive value of 93% (13/14 subjects with EDV ≥8% were MPI-). Conclusions: Endothelial function in asymptomatic patients with T2DM is not associated with the presence of relative myocardial ischemia by MPI; however, an EDV of 8% or greater has a high negative predictive value for the exclusion of CAD.",

keywords = "Endothelial function, myocardial perfusion imaging, type 2 diabetes mellitus",

author = "Papaioannou, {Georgios I.} and Christos Kasapis and Seip, {Richard L.} and Grey, {Neil J.} and Deborah Katten and Wackers, {Frans J.Th} and Inzucchi, {Silvio E.} and Samuel Engel and Amy Taylor and Young, {Lawrence H.} and Chyun, {Deborah A.} and Davey, {Janice A.} and Iskandrian, {Ami E.} and Ratner, {Robert E.} and Robinson, {Evelyn C.} and Stella Carolan and Heller, {Gary V.}",

note = "Funding Information: The study was supported by grants from Hartford Hospital Research Administration, Hartford, Conn; Bristol-Myers Squibb Medical Imaging, North Billerica, Mass; and Astellas Pharma US, Inc, Deerfield, Ill. ",

year = "2006",

month = jun,

doi = "10.1016/j.nuclcard.2006.01.022",

language = "English (US)",

volume = "13",

pages = "362--368",

journal = "Journal of Nuclear Cardiology",

issn = "1071-3581",

publisher = "American Society of Nuclear Cardiology",

number = "3",

}

TY - JOUR

T1 - Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging

AU - Papaioannou, Georgios I.

AU - Kasapis, Christos

AU - Seip, Richard L.

AU - Grey, Neil J.

AU - Katten, Deborah

AU - Wackers, Frans J.Th

AU - Inzucchi, Silvio E.

AU - Engel, Samuel

AU - Taylor, Amy

AU - Young, Lawrence H.

AU - Chyun, Deborah A.

AU - Davey, Janice A.

AU - Iskandrian, Ami E.

AU - Ratner, Robert E.

AU - Robinson, Evelyn C.

AU - Carolan, Stella

AU - Heller, Gary V.

N1 - Funding Information: The study was supported by grants from Hartford Hospital Research Administration, Hartford, Conn; Bristol-Myers Squibb Medical Imaging, North Billerica, Mass; and Astellas Pharma US, Inc, Deerfield, Ill.

PY - 2006/6

Y1 - 2006/6

N2 - Background: Endothelial dysfunction precedes overt atherosclerosis and is present in patients with type 2 diabetes mellitus (T2DM). Myocardial perfusion imaging (MPI) is an effective method of detection of coronary artery disease (CAD); however, the relationship between endothelial function and MPI in asymptomatic patients with T2DM has not been examined. Methods and Results: This study used a subset of the population from the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. Endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation (EIV) were measured by use of brachial artery ultrasonography in 75 asymptomatic patients with T2DM (56 men; mean age, 58.6 ± 6.4 years; mean duration of diabetes, 8.4 ± 7.5 years) who underwent adenosine MPI. Of the patients, 15 (20%) had evidence of relative ischemia (MPI+) whereas 60 (80%) had a normal study (MPI-). Both EDV (3.5% ± 3.7% vs 4.5% ± 6.6%, P = not significant) and EIV (15.1% ± 7.5% vs 16.8% ± 8.4%, P = not significant) were similar in the 2 groups. On the basis of a receiver-operator analysis, an EDV response of 8% was selected as a cut point, with a negative predictive value of 93% (13/14 subjects with EDV ≥8% were MPI-). Conclusions: Endothelial function in asymptomatic patients with T2DM is not associated with the presence of relative myocardial ischemia by MPI; however, an EDV of 8% or greater has a high negative predictive value for the exclusion of CAD.

AB - Background: Endothelial dysfunction precedes overt atherosclerosis and is present in patients with type 2 diabetes mellitus (T2DM). Myocardial perfusion imaging (MPI) is an effective method of detection of coronary artery disease (CAD); however, the relationship between endothelial function and MPI in asymptomatic patients with T2DM has not been examined. Methods and Results: This study used a subset of the population from the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. Endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation (EIV) were measured by use of brachial artery ultrasonography in 75 asymptomatic patients with T2DM (56 men; mean age, 58.6 ± 6.4 years; mean duration of diabetes, 8.4 ± 7.5 years) who underwent adenosine MPI. Of the patients, 15 (20%) had evidence of relative ischemia (MPI+) whereas 60 (80%) had a normal study (MPI-). Both EDV (3.5% ± 3.7% vs 4.5% ± 6.6%, P = not significant) and EIV (15.1% ± 7.5% vs 16.8% ± 8.4%, P = not significant) were similar in the 2 groups. On the basis of a receiver-operator analysis, an EDV response of 8% was selected as a cut point, with a negative predictive value of 93% (13/14 subjects with EDV ≥8% were MPI-). Conclusions: Endothelial function in asymptomatic patients with T2DM is not associated with the presence of relative myocardial ischemia by MPI; however, an EDV of 8% or greater has a high negative predictive value for the exclusion of CAD.

KW - Endothelial function

KW - myocardial perfusion imaging

KW - type 2 diabetes mellitus

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JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

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ER -

Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging

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