Myocardial perfusion in patients with diabetes mellitus according to stress CMR with adenosine triphosphate

Aim. To evaluate the features of myocardial perfusion according to stress CMR with adenosine triphosphate (ATP) in patients with type 2 diabetes mellitus (DM) and obstructive and non-obstructive coronary arteries (CA).

Materials and Methods. Stress СMR with ATP was provided in 55 patients with a suspected or known ischemic heart disease. 39 patients of them had DM type 2. All patients were provided with invasive coronary angiography or non-invasive CT angiogram to evaluate lesions of CA. Study protocol included providing myocardial perfusion in a rest and stress with ATP in dose 160 mkg/ kg/min during 3-6 min.

Results. The detection of stress-induced perfusion defects was statistically significantly associated with the obstructive CA lesions of more than 50% (p<0,001). With non-obstructive CA lesions less than 50%, perfusion defects were found more often in patients with DM (36.4%) than in patients without DM (16.7%). Furthermore, the detection of stress-induced myocardial ischemia of patients with DM was not statistically significantly associated with obstructive CA (p=0,071) In case of positive result of stress CMR, patients with DM had a more widespread zone of stress-induced ischemia in the form of increase involved segments (6,45±3,78 (4,78-8,13) than patients without DM (3,17±1,60 (1,49-4,85), p=0,050).

Conclusion. Patients with DM and non-obstructive CA are more likely to have a myocardial perfusion disorder than patients without DM due to coronary microvascular dysfunction.

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