Cardiac autonomic neuropathy in patients with diabetes and no symptoms of coronary artery disease: Comparison of 123I-metaiodobenzylguanidine myocardial scintigraphy and heart rate variability

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Abstract

Purpose: The purpose of this study was to evaluate the prevalence of cardiac autonomic neuropathy (CAN) in a cohort of patients with type 2 diabetes, truly asymptomatic for coronary artery disease (CAD), using heart rate variability (HRV) and 123I-metaiodobenzylguanidine ( 123I-mIBG) myocardial scintigraphy. Methods: The study group comprised 88 patients with type 2 diabetes prospectively recruited from an outpatient diabetes clinic. In all patients myocardial perfusion scintigraphy, CAN by HRV and 123I-mIBG myocardial scintigraphy were performed. Two or more abnormal tests were defined as CAN-positive (ECG-based CAN) and one or fewer as CAN-negative. CAN assessed by 123I-mIBG scintigraphy was defined as abnormal if the heart-to-mediastinum ratio was <1.8, the washout rate was >25%, or the total defect score was >13. Results: The prevalence of CAN in patients asymptomatic for CAD with type 2 diabetes and normal myocardial perfusion assessed by HRV and 123I-mIBG scintigraphy was respectively, 27% and 58%. Furthermore, in almost half of patients with normal HRV, 123I-mIBG scintigraphy showed CAN. Conclusion: The current study revealed a high prevalence of CAN in patients with type 2 diabetes. Secondly, disagreement between HRV and 123I-mIBG scintigraphy for the assessment of CAN was observed. © 2010 The Author(s).

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Scholte, A. J. H. A., Schuijf, J. D., Delgado, V., Kok, J. A., Bus, M. T. J., Maan, A. C., … Bax, J. J. (2010). Cardiac autonomic neuropathy in patients with diabetes and no symptoms of coronary artery disease: Comparison of 123I-metaiodobenzylguanidine myocardial scintigraphy and heart rate variability. European Journal of Nuclear Medicine and Molecular Imaging, 37(9), 1698–1705. https://doi.org/10.1007/s00259-010-1442-0

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