The Relationship between Retinopathy in Diabetes Mellitus Type 2 and Severity and Extent of Myocardial Ischemia in Myocardial Perfusion Imaging

Malek, Hadi; Hedayati, Raheleh; Yaghoobi, Nahid; Behnia, Mahdi; Rastgou, Fereydoon; Bitarafan Rajabi, Ahmad; Amouzadeh, Hedieh; Hosseini, Shirin; Firoozabadi, Hassan

The Relationship between Retinopathy in Diabetes Mellitus Type 2 and Severity and Extent of Myocardial Ischemia in Myocardial Perfusion Imaging

Document Type : Original Article

Authors

Hadi Malek ¹

Raheleh Hedayati ¹

Nahid Yaghoobi ¹

Mahdi Behnia ²

Fereydoon Rastgou ¹

Ahmad Bitarafan Rajabi ¹

Hedieh Amouzadeh ¹

Shirin Hosseini ³

Hassan Firoozabadi ¹

¹ Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.

² Noor Eye Hospital Ophtalmology Research Center, Tehran, IR Iran.

³ Rajaie Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.

Abstract

Objectives: Diabetes mellitus type 2 (DM2) is one of the leading causes of morbidity and
mortality owing to its role in the development of cardiovascular disease. This study sought to
evaluate the relationship between diabetic retinopathy (DR) and myocardial ischemia using
myocardial perfusion imaging (MPI).
Materials and Methods: Thirty-three patients with DM2 (age =59 ± 8 years) were examined for
evidence of DR. The subjects were divided into two groups on the basis of the presence [DR(+)]
or absence [DR(-)] of diabetic retinopathy. MPI was performed for all the patients as well.
Results: Eighteen and fifteen patients were categorized as DR(+) and DR(-), respectively.
Ischemia was significantly more frequent in the DR(+) group than in the DR(-) group (p <0.05).
There was also a positive association between the grade of retinopathy and the grade of ischemia
(odds ratio (OR)[confidence interval (CI)95%] =7.1 [1.7-29.6], p =0.007). Severe
nonproliferative/proliferative DR was independently related to the summed difference and
summed stress scores (β=13.2, p =0.024 and β=15.4, p =0.013, respectively).
Conclusion: The results of our study suggest that the presence of DR increases the risk of
abnormal perfusion and the degree of retinopathy is correlated with the extent and severity of
ischemia in patients with DM2. (Iranian Heart Journal 2013; 13(4):6-14 ).

Keywords

Diabetes mellitus

Diabetic retinopathy

Ischemic heart disease

Myocardial perfusion imaging