Abstract
Introduction.
In patients with type 2 diabetes mellitus (T2DM), myocardial ischemia often develops in the presence of non-obstructive coronary artery disease (NOCAD), indicating a leading role of coronary microvascular dysfunction (CMD). Quantitative assessment of myocardial flow reserve (MFR) using dynamic SPECT with semiconductor detectors (CZT) represents a promising yet understudied approach in this cohort.
Aim:
To determine the functional characteristics of the microcirculatory bed in patients with T2DM and NOCAD using dynamic CZT-SPECT myocardial perfusion imaging. Material and methods. The study included 75 patients with NOCAD: 36 with T2DM and 39 without diabetes. All patients underwent dynamic myocardial SPECT with ⁹⁹ᵐTc-MIBI and perfusion ECG‑gated SPECT. Semi-quantitative perfusion parameters, absolute values of myocardial blood flow (MBF) at rest and during stress, and MFR were assessed.
Results.
Compared with the non-diabetic group, patients with T2DM demonstrated statistically significantly higher summed perfusion defect scores (p
Conclusion.
For the first time, using dynamic CZT-SPECT, it was demonstrated that in patients with T2DM and NOCAD the key hemodynamic abnormality is an increase in resting MBF, which leads to a reduction in MFR and may indicate early CMD. Quantitative assessment of MBF components by dynamic CZT-SPECT expands diagnostic capabilities and may serve as a basis for cardiovascular risk stratification in this patient group.