Perspectives of nuclear diagnostic imaging in diabetic cardiomyopathy

Sasso, F.C.; Rambaldi, P.F.; Carbonara, O.; Nasti, R.; Torella, M.; Rotondo, A.; Torella, R.; Mansi, L.

doi:10.1016/j.numecd.2009.08.013

« Previous Next »Nutrition, Metabolism & Cardiovascular Diseases
Volume 20, Issue 3 , Pages 208-216, March 2010

Perspectives of nuclear diagnostic imaging in diabetic cardiomyopathy

F.C. Sasso
- Unit of Internal Medicine, Dept. of Clinical and Experimental Medicine “Magrassi-Lanzara”, Second University of Naples, Naples, Italy
- Excellence Centre for Cardiovascular Disease, Second University of Naples, Italy
- Corresponding author. Unit of Internal Medicine, Dept. of Clinical and Experimental Medicine “Magrassi-Lanzara”, Excellence Centre for Cardiovascular Disease, Second University of Naples, Via F. Petrarca, 64, I-80122 Naples, Italy. Tel.: +39 081 5666707; fax: +39 081 5666736.
P.F. Rambaldi
- Nuclear Medicine, Dept. of Clinical and Experimental Medicine “Magrassi-Lanzara”, Second University of Naples, Italy
- Excellence Centre for Cardiovascular Disease, Second University of Naples, Italy
O. Carbonara
- Unit of Internal Medicine, Dept. of Clinical and Experimental Medicine “Magrassi-Lanzara”, Second University of Naples, Naples, Italy
- Excellence Centre for Cardiovascular Disease, Second University of Naples, Italy
R. Nasti
- Unit of Internal Medicine, Dept. of Clinical and Experimental Medicine “Magrassi-Lanzara”, Second University of Naples, Naples, Italy
- Excellence Centre for Cardiovascular Disease, Second University of Naples, Italy
M. Torella
- Cardiac Surgery, Second University of Naples, Italy
A. Rotondo
- Nuclear Medicine, Dept. of Clinical and Experimental Medicine “Magrassi-Lanzara”, Second University of Naples, Italy
- Excellence Centre for Cardiovascular Disease, Second University of Naples, Italy
R. Torella
- Unit of Internal Medicine, Dept. of Clinical and Experimental Medicine “Magrassi-Lanzara”, Second University of Naples, Naples, Italy
- Excellence Centre for Cardiovascular Disease, Second University of Naples, Italy
L. Mansi
- Nuclear Medicine, Dept. of Clinical and Experimental Medicine “Magrassi-Lanzara”, Second University of Naples, Italy
- Excellence Centre for Cardiovascular Disease, Second University of Naples, Italy

Received 19 March 2009; received in revised form 23 July 2009; accepted 31 August 2009. published online 27 November 2009.

Abstract

Diabetic cardiomyopathy is a ventricular dysfunction in the absence of coronary artery disease, valvular or hypertensive heart disease. The mechanisms underlying diabetic cardiomyopathy may involve metabolic disturbances, myocardial fibrosis, small vessel disease, microcirculation abnormalities, cardiac autonomic neuropathy and insulin resistance.

Diagnostic problems emerge because no specific disease pattern characterizes the disease and because there may be coexistence in diabetes of coronary artery disease and hypertension as independent but compounding causes of biochemical, anatomical and functional alterations impairing cardiac function.

In this paper we will review the role of nuclear imaging today, concentrating on the diagnostic capabilities of radionuclide ventriculography, to study the effect of insulin resistance and, more extensively, gated-single photon emission computed tomography with Tc-99m labelled agents.

A broad analysis will be dedicated to: 1) positron emission tomography using perfusion agents, with the potential to quantify resting and stress blood flow and coronary flow reserve; 2) radionuclide procedures evaluating aerobic and anaerobic cardiac metabolism; and 3) cardiac neurotransmission imaging, studying the autonomic neuropathy.

Keywords: Imaging, Cardiomyopathy, Diabetes