Qi Yiming, Li Lihua, Feng Guoquan, Shao Chen, Cai Yue, Wang Zhongqun
Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Department of Pathology, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Front Cardiovasc Med. 2021 Sep 21;8:713971. doi: 10.3389/fcvm.2021.713971. eCollection 2021.
Diabetes is a complex metabolic disease characterized by hyperglycemia. Its complications are various, often involving the heart, brain, kidney, and other essential organs. At present, the number of diabetic patients in the world is growing day by day. The cardiovascular disease caused by diabetes has dramatically affected the quality of life of diabetic patients. It is the leading cause of death of diabetic patients. Diabetic patients often suffer from microvascular angina pectoris without obstructive coronary artery disease. Still, there are typical ECG ischemia and angina pectoris, that is, chest pain and dyspnea under exercise. Unlike obstructive coronary diseases, nitrate does not affect chest pain caused by coronary microvascular angina in most cases. With the increasing emphasis on diabetic microvascular angina, the need for accurate diagnosis of the disease is also increasing. We can use SPECT, PET, CMR, MCE, and other methods to evaluate coronary microvascular function. SPECT is commonly used in clinical practice, and PET is considered the gold standard for non-invasive detection of myocardial blood flow. This article mainly introduces the research progress of these imaging methods in detecting microvascular angina in diabetic patients.
糖尿病是一种以高血糖为特征的复杂代谢性疾病。其并发症多种多样,常累及心脏、大脑、肾脏等重要器官。目前,全球糖尿病患者数量日益增多。糖尿病引发的心血管疾病极大地影响了糖尿病患者的生活质量,是糖尿病患者的主要死因。糖尿病患者常患有无微阻塞性冠状动脉疾病的微血管性心绞痛,仍存在典型的心电图缺血及心绞痛症状,即在运动时出现胸痛和呼吸困难。与阻塞性冠状动脉疾病不同,在大多数情况下,硝酸盐对冠状动脉微血管性心绞痛引起的胸痛并无影响。随着对糖尿病微血管性心绞痛的日益重视,对该疾病准确诊断的需求也在增加。我们可以使用单光子发射计算机断层扫描(SPECT)、正电子发射断层扫描(PET)、心脏磁共振成像(CMR)、心肌对比增强(MCE)等方法来评估冠状动脉微血管功能。SPECT在临床实践中常用,PET被认为是无创检测心肌血流的金标准。本文主要介绍这些成像方法在检测糖尿病患者微血管性心绞痛方面的研究进展。