Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function

Panithaya Chareonthaitawee; Paul Sorajja; Navin Rajagopalan; Todd D. Miller; David O. Hodge; Robert L. Frye; Raymond J. Gibbons

doi:10.1016/j.ahj.2007.04.042

Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function

Panithaya Chareonthaitawee, Paul Sorajja, Navin Rajagopalan, Todd D. Miller, David O. Hodge, Robert L. Frye, Raymond J. Gibbons

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Background: The prevalence and prognosis of reduced left ventricular ejection fraction (LVEF) in asymptomatic diabetic patients without known coronary artery disease (CAD) are not known. Methods: We examined 1046 asymptomatic diabetic patients (age 60 ± 13 years, 69% male) without known CAD referred to a tertiary referral center for stress single-photon emission computed tomography (SPECT) and assessment of LVEF. Patients were stratified according to the presence of normal LVEF (≥50%), mildly reduced LVEF (35%-49%), or moderately/severely reduced LVEF (<35%). Single-photon emission computed tomographic images were classified as low, intermediate, or high risk based on the summed stress score (normal = 56). The mean follow-up was 5.3 ± 3.3 years. Results: The prevalence of reduced LVEF was 16.7% (n = 175, mean LVEF 40.0% ± 7.7%). This group was older (63 ± 11 vs 59 ± 14 years, P = .005), had more peripheral arterial disease (45% vs 29%, P < .001), and had a higher prevalence of electrocardiographic Q waves (21% vs 9%, P < .001) than the group without reduced LVEF. Mean summed stress (44.8 ± 9.8 vs 51.7 ± 6.3, P < .001), summed reversibility (4.7 ± 5.0 vs 2.9 ± 4.5, P < .001), and summed rest scores (49.4 ± 7.2 vs 54.6 ± 3.1, P < .001) were significantly more abnormal in the reduced LVEF group. High-risk summed stress score was significantly more common in the reduced LVEF group (46% vs 16%, P < .001). Survival was significantly lower in patients with any reduction in LVEF compared with those without reduced LVEF (10-year survival, 29% vs 57%, P < .0001). By multivariate analysis, reduced LVEF was independently associated with increased mortality (adjusted χ² = 6.26, P = .01). Conclusions: In this population of asymptomatic diabetic patients without known CAD referred for stress SPECT, 1 in 6 patients had reduced LVEF. Most of these patients have intermediate-/high-risk SPECT scans. The annual mortality rates of the groups with and without reduced LVEF were 7% and 4%, respectively.

Original language	English
Pages (from-to)	567-574
Number of pages	8
Journal	American Heart Journal
Volume	154
Issue number	3
DOIs	https://doi.org/10.1016/j.ahj.2007.04.042
State	Published - Sep 2007

Bibliographical note

Funding Information:
Dr Chareonthaitawee was supported by a research grant from King Pharmaceuticals, Cary, NC; Dr Miller by research grants from Bristol-Myers Squibb, North Billerica, MA, and King Pharmaceuticals); and Dr Gibbons by a research grant from King Pharmaceuticals.

Funding

Dr Chareonthaitawee was supported by a research grant from King Pharmaceuticals, Cary, NC; Dr Miller by research grants from Bristol-Myers Squibb, North Billerica, MA, and King Pharmaceuticals); and Dr Gibbons by a research grant from King Pharmaceuticals.

Funders	Funder number
Bristol-Myers Squibb
King Pharmaceuticals

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Chareonthaitawee, P., Sorajja, P., Rajagopalan, N., Miller, T. D., Hodge, D. O., Frye, R. L., & Gibbons, R. J. (2007). Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function. American Heart Journal, 154(3), 567-574. https://doi.org/10.1016/j.ahj.2007.04.042

Chareonthaitawee, Panithaya ; Sorajja, Paul ; Rajagopalan, Navin et al. / Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function. In: American Heart Journal. 2007 ; Vol. 154, No. 3. pp. 567-574.

@article{f5d07f91b9614087999746f08fdeba07,

title = "Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function",

abstract = "Background: The prevalence and prognosis of reduced left ventricular ejection fraction (LVEF) in asymptomatic diabetic patients without known coronary artery disease (CAD) are not known. Methods: We examined 1046 asymptomatic diabetic patients (age 60 ± 13 years, 69\% male) without known CAD referred to a tertiary referral center for stress single-photon emission computed tomography (SPECT) and assessment of LVEF. Patients were stratified according to the presence of normal LVEF (≥50\%), mildly reduced LVEF (35\%-49\%), or moderately/severely reduced LVEF (<35\%). Single-photon emission computed tomographic images were classified as low, intermediate, or high risk based on the summed stress score (normal = 56). The mean follow-up was 5.3 ± 3.3 years. Results: The prevalence of reduced LVEF was 16.7\% (n = 175, mean LVEF 40.0\% ± 7.7\%). This group was older (63 ± 11 vs 59 ± 14 years, P = .005), had more peripheral arterial disease (45\% vs 29\%, P < .001), and had a higher prevalence of electrocardiographic Q waves (21\% vs 9\%, P < .001) than the group without reduced LVEF. Mean summed stress (44.8 ± 9.8 vs 51.7 ± 6.3, P < .001), summed reversibility (4.7 ± 5.0 vs 2.9 ± 4.5, P < .001), and summed rest scores (49.4 ± 7.2 vs 54.6 ± 3.1, P < .001) were significantly more abnormal in the reduced LVEF group. High-risk summed stress score was significantly more common in the reduced LVEF group (46\% vs 16\%, P < .001). Survival was significantly lower in patients with any reduction in LVEF compared with those without reduced LVEF (10-year survival, 29\% vs 57\%, P < .0001). By multivariate analysis, reduced LVEF was independently associated with increased mortality (adjusted χ2 = 6.26, P = .01). Conclusions: In this population of asymptomatic diabetic patients without known CAD referred for stress SPECT, 1 in 6 patients had reduced LVEF. Most of these patients have intermediate-/high-risk SPECT scans. The annual mortality rates of the groups with and without reduced LVEF were 7\% and 4\%, respectively.",

author = "Panithaya Chareonthaitawee and Paul Sorajja and Navin Rajagopalan and Miller, \{Todd D.\} and Hodge, \{David O.\} and Frye, \{Robert L.\} and Gibbons, \{Raymond J.\}",

note = "Funding Information: Dr Chareonthaitawee was supported by a research grant from King Pharmaceuticals, Cary, NC; Dr Miller by research grants from Bristol-Myers Squibb, North Billerica, MA, and King Pharmaceuticals); and Dr Gibbons by a research grant from King Pharmaceuticals. ",

year = "2007",

month = sep,

doi = "10.1016/j.ahj.2007.04.042",

language = "English",

volume = "154",

pages = "567--574",

number = "3",

}

Chareonthaitawee, P, Sorajja, P, Rajagopalan, N, Miller, TD, Hodge, DO, Frye, RL & Gibbons, RJ 2007, 'Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function', American Heart Journal, vol. 154, no. 3, pp. 567-574. https://doi.org/10.1016/j.ahj.2007.04.042

Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function. / Chareonthaitawee, Panithaya; Sorajja, Paul; Rajagopalan, Navin et al.
In: American Heart Journal, Vol. 154, No. 3, 09.2007, p. 567-574.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function

AU - Chareonthaitawee, Panithaya

AU - Sorajja, Paul

AU - Rajagopalan, Navin

AU - Miller, Todd D.

AU - Hodge, David O.

AU - Frye, Robert L.

AU - Gibbons, Raymond J.

N1 - Funding Information: Dr Chareonthaitawee was supported by a research grant from King Pharmaceuticals, Cary, NC; Dr Miller by research grants from Bristol-Myers Squibb, North Billerica, MA, and King Pharmaceuticals); and Dr Gibbons by a research grant from King Pharmaceuticals.

PY - 2007/9

Y1 - 2007/9

N2 - Background: The prevalence and prognosis of reduced left ventricular ejection fraction (LVEF) in asymptomatic diabetic patients without known coronary artery disease (CAD) are not known. Methods: We examined 1046 asymptomatic diabetic patients (age 60 ± 13 years, 69% male) without known CAD referred to a tertiary referral center for stress single-photon emission computed tomography (SPECT) and assessment of LVEF. Patients were stratified according to the presence of normal LVEF (≥50%), mildly reduced LVEF (35%-49%), or moderately/severely reduced LVEF (<35%). Single-photon emission computed tomographic images were classified as low, intermediate, or high risk based on the summed stress score (normal = 56). The mean follow-up was 5.3 ± 3.3 years. Results: The prevalence of reduced LVEF was 16.7% (n = 175, mean LVEF 40.0% ± 7.7%). This group was older (63 ± 11 vs 59 ± 14 years, P = .005), had more peripheral arterial disease (45% vs 29%, P < .001), and had a higher prevalence of electrocardiographic Q waves (21% vs 9%, P < .001) than the group without reduced LVEF. Mean summed stress (44.8 ± 9.8 vs 51.7 ± 6.3, P < .001), summed reversibility (4.7 ± 5.0 vs 2.9 ± 4.5, P < .001), and summed rest scores (49.4 ± 7.2 vs 54.6 ± 3.1, P < .001) were significantly more abnormal in the reduced LVEF group. High-risk summed stress score was significantly more common in the reduced LVEF group (46% vs 16%, P < .001). Survival was significantly lower in patients with any reduction in LVEF compared with those without reduced LVEF (10-year survival, 29% vs 57%, P < .0001). By multivariate analysis, reduced LVEF was independently associated with increased mortality (adjusted χ2 = 6.26, P = .01). Conclusions: In this population of asymptomatic diabetic patients without known CAD referred for stress SPECT, 1 in 6 patients had reduced LVEF. Most of these patients have intermediate-/high-risk SPECT scans. The annual mortality rates of the groups with and without reduced LVEF were 7% and 4%, respectively.

AB - Background: The prevalence and prognosis of reduced left ventricular ejection fraction (LVEF) in asymptomatic diabetic patients without known coronary artery disease (CAD) are not known. Methods: We examined 1046 asymptomatic diabetic patients (age 60 ± 13 years, 69% male) without known CAD referred to a tertiary referral center for stress single-photon emission computed tomography (SPECT) and assessment of LVEF. Patients were stratified according to the presence of normal LVEF (≥50%), mildly reduced LVEF (35%-49%), or moderately/severely reduced LVEF (<35%). Single-photon emission computed tomographic images were classified as low, intermediate, or high risk based on the summed stress score (normal = 56). The mean follow-up was 5.3 ± 3.3 years. Results: The prevalence of reduced LVEF was 16.7% (n = 175, mean LVEF 40.0% ± 7.7%). This group was older (63 ± 11 vs 59 ± 14 years, P = .005), had more peripheral arterial disease (45% vs 29%, P < .001), and had a higher prevalence of electrocardiographic Q waves (21% vs 9%, P < .001) than the group without reduced LVEF. Mean summed stress (44.8 ± 9.8 vs 51.7 ± 6.3, P < .001), summed reversibility (4.7 ± 5.0 vs 2.9 ± 4.5, P < .001), and summed rest scores (49.4 ± 7.2 vs 54.6 ± 3.1, P < .001) were significantly more abnormal in the reduced LVEF group. High-risk summed stress score was significantly more common in the reduced LVEF group (46% vs 16%, P < .001). Survival was significantly lower in patients with any reduction in LVEF compared with those without reduced LVEF (10-year survival, 29% vs 57%, P < .0001). By multivariate analysis, reduced LVEF was independently associated with increased mortality (adjusted χ2 = 6.26, P = .01). Conclusions: In this population of asymptomatic diabetic patients without known CAD referred for stress SPECT, 1 in 6 patients had reduced LVEF. Most of these patients have intermediate-/high-risk SPECT scans. The annual mortality rates of the groups with and without reduced LVEF were 7% and 4%, respectively.

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Chareonthaitawee P, Sorajja P, Rajagopalan N, Miller TD, Hodge DO, Frye RL et al. Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function. American Heart Journal. 2007 Sep;154(3):567-574. doi: 10.1016/j.ahj.2007.04.042

Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function

Abstract

Bibliographical note

Funding

ASJC Scopus subject areas

UN SDGs

Access to Document

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