Impact of diabetes on viable myocardium in elderly coronary heart disease patients without myocardial infarction
10.3969/j.issn.1009-0126.2023.10.009
- VernacularTitle:糖尿病对未发生过心肌梗死的老年冠心病患者存活心肌的影响
- Author:
Honghong LIU
1
;
Donghua ZHANG
;
Yonghong YANG
;
Yun GAO
;
Qian WANG
;
Yun LIN
Author Information
1. 100029 首都医科大学附属北京安贞医院心内科
- Keywords:
coronary disease;
myocardial infarction;
diabetes mellitus;
positron-emission tomography
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2023;25(10):1042-1045
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of diabetes on the surviving myocardium in elderly patients with coronary heart disease(CHD)but without myocardial infarction.Methods A total of 122 elderly patients admitted to our hospital from June 2019 to September 2022 and had been diagnosed with CHD but had not haven myocardial infarction were enrolled,and then divided into surviving myocardium group(68 cases)and non-surviving myocardium group(54 cases),and also divided into diabetic group(72 cases)and non-diabetic group(50 cases).Resting and exercise load myocardial perfusion single photon emission computed tomography and 18F-FDG myocardial posi-tron emission computed tomography were performed on all the patients to analyze the surviving myocardium and the influencing factors.Results The surviving myocardium group had signifi-cantly lower proportions of diabetes and obesity than the non-surviving myocardium group(33.8％vs 90.7％,P＜0.01;17.6％vs 38.9％,P＜0.01).The diabetic group presented obviously larger proportions of absence of activity,hypertension and obesity(P＜0.05,P＜0.01),while low-er ratios of viable myocardium in the anterior,inferior,lateral,and septal walls in each ischemia area(P＜0.01)when compared with the non-diabetic patients.Single factor logistic regression analysis showed that diabetes was a risk factor for increasing ratio of non-surviving myocardium in ischemic myocardial area(95％CI:6.721-54.703,P=0.001).Multifactor logistic regression analysis indicated that after adjusting for age and sex,and further adjusting for obesity,the rela-tive risk of diabetes was 24.564(95％CI:7.464-80.865,P=0.001).Conclusion Diabetes signifi-cantly reduces the amount of viable myocardium in the elderly CHD patients.It is recommended that for the CHD patients without myocardial infarction,especially those complicated with diabe-tes,evaluation for viable myocardium in ischemic area is essential.
