Objectives Diabetes mellitus is considered as an equivalent of coronary
artery disease (CAD). Aim of the study was to investigate whether in
asymptomatic patients with type II diabetes, diastolic stress
echocardiography may represent an alternative tool for the detection of
CAD.
Methods The study population consisted of 105 patients with diabetes
mellitus (age 61 +/- 9 years, 26% female, duration of diabetes 37 +/-
14 months). We performed an exercise stress test, followed by an
echo-study and a single-positron emission tomography. Coronary
angiography was performed within 1 month.
Results Coronary angiography revealed a coronary artery stenosis of at
least 70% in 72 patients (69%, CAD group), while the remaining formed
the non-CAD group. Exercise induced an increase of both E/E’ lateral and
septal ratios as well as their average in the CAD group and on the
contrary a decrease of these ratios in the non-CAD group. Receiver
operating curve analysis for discrimination between patients with and
without obstructive CAD showed an optimal cut-off value of - 0.0708 for
the exercise-induced change of E/E’ average (area under curve 0.892, P <
0.001). Sensitivities of scintigraphy and of diastolic stress
echocardiography for detection of CAD were 75.0 and 93.1%,
respectively; specificity was 78.8% for both methods. In asymptomatic
patients, sensitivities of scintigraphy and diastolic stress
echocardiography were 76.9 and 92.3%; specificity of both was 80%.
Conclusion In patients with type II diabetes, diastolic stress
echocardiography, by means of E/E’ ratio exercise-induced changes, can
be used for the diagnosis and severity of CAD and for the detection of
occult myocardial ischemia. Coron Artery Dis 21:104-112 (C) 2010 Wolters
Kluwer Health vertical bar Lippincott Williams & Wilkins
