Cardiac Tests in Asymptomatic Type 2 Diabetics
Cardiac Tests in Asymptomatic Type 2 Diabetics
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无症状 2 型糖尿病患者的心脏检查
DOI：
10.1159/000065818
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发表时间：
2002
影响因子：
3.2
通讯作者：
S. Sadanandan
中科院分区：
文献类型：
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作者：
Abdulnabi T Alattar;S. Mahussain;S. Sadanandan
目的：评价无创性方法检测无症状2型糖尿病患者心肌缺血及其与其他并存临床因素的关系。主题和方法：对42例2型糖尿病患者进行了负荷运动耐量试验（ETT）、12导联心电图（ECG）、经胸超声心动图和~（99）Tc-替曲膦负荷心肌灌注显像。结果如下：11例（26.2%）患者在ETT上显示缺血模式，仅2例（4.8%）静息心电图提示缺血，9例（21.4%）超声心动图显示舒张功能障碍，3例（7.3%）负荷心肌灌注扫描显示缺血。对于57岁以上的受试者，年龄与缺血性ETT（p = 0.026）和超声心动图舒张功能障碍（p = 0.044）之间存在显著差异。微量白蛋白尿和/或舒张功能不全的患者比其他患者更容易发生缺血性ETT（分别为p = 0.036和0.024），舒张功能不全的患者缺血性ETT的患病率更高。缺血性ETT与其他主要心脏风险因素（高血压、血脂异常、吸烟、性别、糖尿病病程、BMI和糖化血红蛋白水平）之间无相关性。结论：心脏ETT对无症状2型糖尿病患者心肌缺血的诊断最有价值。对于不明确的ETT结果，建议进行超声心动图检查。2型糖尿病患者心肌缺血发生率高。
Objective: To evaluate the use of noninvasive procedures for the detection of myocardial ischemia and its relation with other coexistent clinical factors in patients with asymptomatic type 2 diabetes mellitus. Subjects and Methods: A total of 42 patients with type 2 diabetes mellitus, aged 41–72 years with no clinical history suggestive of coronary heart disease, were evaluated for silent myocardial ischemia by stress cardiac exercise tolerance test (ETT), 12-lead electrocardiography (ECG), transthoracic echocardiography and stress myocardial perfusion scan using technetium-99m tetrofosmin. Results: Eleven patients (26.2%) showed an ischemic pattern on ETT, the resting ECG was suggestive of ischemia in only 2 (4.8%), echocardiography showed diastolic dysfunction in 9 (21.4%), and the stress myocardial perfusion scan was ischemic in 3 (7.3%). For subjects over the age of 57, a significant difference was found between age and ischemic ETT (p = 0.026) and diastolic dysfunction by echocardiography (p = 0.044). Patients with microalbuminuria and/or diastolic dysfunction were more likely than others to have ischemic ETT (p = 0.036 and 0.024, respectively) and patients with diastolic dysfunction had a higher prevalence of ischemic ETT. There was no relation between ischemic ETT and other major cardiac risk factors (hypertension, dyslipidemia, smoking, sex, duration of diabetes, BMI, and glycated hemoglobin levels). Conclusion: The cardiac ETT was most helpful for detecting myocardial ischemia in asymptomic type 2 diabetics. For equivocal ETT findings, echocardiography is recommended. The prevalence of myocardial ischemia was high in patients with type 2 diabetes mellitus.