Authors: Penfornis, A.¹; Zimmermann, C.¹; Boumal, D.²; Sabbah, A.³; Meneveau, N.²; Gaultier-Bourgeois, S.¹; Bassand, J. P.²; Bernard, Y.²

Source: Diabetic Medicine, Volume 18, Number 11, November 2001 , pp. 900-905(6)

Publisher: Wiley-Blackwell

Abstract:

Aims 

Silent myocardial ischaemia is frequent in diabetic patients. The aim of this study was to compare the efficacy of thallium-201 single-photon emission computed tomography (²⁰¹Tl SPECT) coupled with exercise stress testing (EST), and dobutamine stress echocardiography (DSE) in the detection of asymptomatic coronary artery disease. Methods 

Fifty-six asymptomatic diabetic patients, with a known duration of diabetes > 15 years for Type 1 and > 5 years for Type 2, having at least three added risk factors, but without rest ECG abnormalities, were enrolled in this prospective study. All of them were submitted to DSE with a maximum infusion rate of 40 µg/kg per min dobutamine ± i.v. atropine, and to ²⁰¹Tl SPECT coupled with EST. Coronary angiography was performed if at least one test was abnormal. Results 

Diabetic patients were 37 males and 19 females, aged mean (sd) 60 ± 10 years, 10 Type 1 and 46 Type 2, with a known duration of disease of mean (sd) 17 ± 9 years. Feasibility of DSE was 91%. No serious complication occurred during the test. Coronary angiography was performed in 26 patients (47%); 17 were abnormal (30% of the whole group): six patients had a one-vessel, six a two-vessel and five a three-vessel disease. Predictive positive value was 69% for DSE, 75% for ²⁰¹Tl SPECT and 60% for EST. DSE was falsely negative in four cases vs. eight for ²⁰¹Tl SPECT and nine for EST. Conclusions 

Asymptomatic coronary disease is common in diabetes associated with other risk factors. DSE appears useful in its detection and a good alternative to ²⁰¹Tl SPECT.

Diabet. Med. 18, 900-905 (2001)

Keywords: dobutamine-atropine stress echocardiography; thallium-201 single-photon emission computed tomog; coronary artery disease; diabetes

Document Type: Research article

Affiliations: 1: Departments of Endocrinology, 2: Cardiology, and 3: Nuclear Medicine, University Hospital, Besançon, France

Publication date: 2001-11-01

Related content

• In this: publication
• By this: publisher
• In this Subject: Internal Medicine
• By this author: Penfornis, A. ;  Zimmermann, C. ;  Boumal, D. ;  Sabbah, A. ;  Meneveau, N. ;  Gaultier-Bourgeois, S. ;  Bassand, J. P. ;  Bernard, Y.

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers