Assessment of Myocardial Perfusion in Patients with Type 2 Diabetes Mellitus With and Without Chronic Kidney Disease

Abstract

We examined 75 patients with T2DM: the control group - patients without CKD (n=10) and the main group - patients with CKD (n=65). The main group was also divided into 2 groups according to estimated GFR (eGFR; in mL/min/1.73m2) by the CKD-EPI: eGFR≥60 (n=45) and eGFR<60 (n=20).MP imaging was performed using SPECT - AnyScan® SC - Mediso with technetium-99m sestamibi. The following scale was used to determine the SRS measure: 0 points - 70% or more, 1 point - 69-50%, 2 points - 49-30%, 3 points - 29-10%, 4 points - 9% and below in 17 segments of the polar map.The average age of patients in the control group was 54.3±9.14, and 30% were men. In the main group, the average age was 58.05±8.0, and 41.5% were men, and their average eGFR was 74.5±26.39 mL/min/1.73m2.70% of patients in the control group had SRS=0, i.e. normal myocardial perfusion at rest. The remaining 30% of patients had a minimally abnormal results (SRS=1-2). The number of patients with normal MP observed decreases when CKD occurs: 46.7% in the group with eGFR>60ml/min and 35% in patients with eGFR<60ml/min. In patients with CKD, not only the number of patients with decreased MP increases, we can observe that its severity also increases: the percentage of patients with the SRS=1-2 is 35.5% and 35%, SRS=3-4 in 15.6% and 10%, and SRS≥5 were 2.22% and 20%, in the groups of GFR>60 and GFR<60 respectively (p=0.041).