Email this article Type 2 diabetes mellitus and coronary artery disease: features of perfusion volume computed tomography of the heart in a pharmacological test with adenosine triphosphate
- Authors: Soboleva G.N.1, Minasyan A.A.1, Gaman S.A.1, Rogoza A.N.1, Molina L.P.2, Soboleva T.V.3, Shariya M.A.1,3, Ternovoy S.K.1,3, Karpov Y.A.1
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Affiliations:
- Chazov National Medical Research Center of Cardiology
- Endocrinological Dispensary
- Sechenov First Moscow State Medical University (Sechenov University)
- Issue: Vol 95, No 4 (2023)
- Pages: 309-315
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/132921
- DOI: https://doi.org/10.26442/00403660.2023.04.202158
- ID: 132921
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Abstract
Aim. To study myocardial perfusion in patients with coronary artery disease (CAD) with and without type 2 diabetes mellitus (DM) using volumetric computed tomography (VCT) of the heart with a pharmacological test with adenosine triphosphate (ATP).
Materials and methods. The study included 93 patients, of which 18 had CAD with DM, and 50 had CAD without DM. All patients underwent one of the stress tests, cardiac VCT with ATP test, invasive coronary angiography, or CT coronary angiography. Left ventricle (LV) myocardial perfusion was evaluated for hypoperfusion zones and the calculation of semi-quantitative indices: decrease of LV myocardial density, LV myocardial perfusion index, transmural perfusion coefficient, and our proposed new indicator – myocardial perfusion reserve (MPR).
Results. The MPR index value in the hypoperfusion zones in patients with CAD and DM was 0.64 [0.62–0.66], in patients with CAD without diabetes 0.65 [0.63–0.66]; p=0.4; the value of the transmural perfusion coefficient in the areas of abnormal LV myocardial perfusion in patients with CAD and DM was 0.81 [0.80–0.86] versus 0.83 [0.80–0.85] in patients with CAD without DM (p=0.6). More hypoperfusion segments were observed in patients with CAD and DM (33.3%) compared to those without DM (14%; p=0.029). The MPR index in the hypoperfusion zones in patients with CAD with intact coronary arteries (CA) and DM was 0.56 [0.54–0.60] versus 0.55 [0.54–0.62] in patients with CAD with intact CA without DM; p=0.2.
Conclusion. In patients with CAD and type 2 DM, according to the VCT with ATP test, more foci hypoperfusion areas were detected, regardless of the severity of coronary artery involvement, compared with patients with CAD without DM, which may be due to the microangiopathy in the myocardium. The similarity of the MPR parameters in the hypoperfusion zones associated with hemodynamic stenosis of the CA and with intact CAs indicates the ischemic genesis of these zones.
For citation: Soboleva GN, Minasyan AA, Gaman SA, Rogoza AN, Molina LP, Soboleva TV, Shariya MA, Ternovoy SK, Karpov YuA. Type 2 diabetes mellitus and coronary artery disease: features of perfusion volume computed tomography of the heart in a pharmacological test with adenosine triphosphate. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(4):309–315. DOI: 10.26442/00403660.2023.04.202158
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##article.viewOnOriginalSite##About the authors
Galina N. Soboleva
Chazov National Medical Research Center of Cardiology
Author for correspondence.
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0002-6484-5884
д-р мед. наук, вед. науч. сотр. отд. ангиологии Научно-исследовательского института клинической кардиологии им. А.Л. Мясникова
Russian Federation, MoscowArevik A. Minasyan
Chazov National Medical Research Center of Cardiology
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0002-9695-0881
аспирант отд. ангиологии Научно-исследовательского института клинической кардиологии им. А.Л. Мясникова
Russian Federation, MoscowSvetlana A. Gaman
Chazov National Medical Research Center of Cardiology
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0002-2165-3911
канд. мед. наук, ст. науч. сотр. отд. томографии диагностики Научно-исследовательского института клинической кардиологии им. А.Л. Мясникова
Russian Federation, MoscowAnatoly N. Rogoza
Chazov National Medical Research Center of Cardiology
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0002-0543-3089
д-р биол. наук, проф., и. о. рук. отд. новых методов диагностики Научно-исследовательского института клинической кардиологии им. А.Л. Мясникова
Russian Federation, MoscowLiudmila P. Molina
Endocrinological Dispensary
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0001-5658-3522
канд. мед. наук, врач-кардиолог
Russian Federation, MoscowTatiana V. Soboleva
Sechenov First Moscow State Medical University (Sechenov University)
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0003-4509-1068
студентка лечебного фак-та
Russian Federation, MoscowMerab A. Shariya
Chazov National Medical Research Center of Cardiology; Sechenov First Moscow State Medical University (Sechenov University)
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0002-0370-5204
д-р мед. наук, вед. науч. сотр. отд. томографии Научно-исследовательского института клинической кардиологии им. А.Л. Мясникова, проф. каф. лучевой диагностики ФГБУ «НМИЦ кардиологии им. акад. Е.И. Чазова»
Russian Federation, Moscow; MoscowSergey K. Ternovoy
Chazov National Medical Research Center of Cardiology; Sechenov First Moscow State Medical University (Sechenov University)
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0003-4374-1063
акад. РАН, д-р мед. наук, проф., гл. науч. сотр. отд. томографии Научно-исследовательского института клинической кардиологии им. А.Л. Мясникова, зав. каф. лучевой диагностики (Сеченовский Университет)
Russian Federation, Moscow; MoscowYuri A. Karpov
Chazov National Medical Research Center of Cardiology
Email: soboleva_galina@inbox.ru
ORCID iD: 0000-0003-1480-0458
д-р мед. наук, проф., гл. науч. сотр. отд. ангиологии Научно-исследовательского института клинической кардиологии им. А.Л. Мясникова
Russian Federation, MoscowReferences
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