Does the Presence of Diabetes Mellitus Make a Difference in Pharmacological Stress Echocardiography Outcome Results?

Abstract

BACKGROUND:Coronary artery disease (CAD) is the leading cause of mortality and morbidity in patients with diabetes (DM).AIM:The aim of our study was to analyse the ability of pharmacological SE to risk stratify patients with DM using qualitative and quantitative assessment of LV function.METHODS:We prospectively assessed 105 consecutive patients (58.7 ± 9.5 y, 39 male) with known or suspected CAD who underwent dipyridamole or dobutamine SE.RESULTS:Change of systolic LV function at maximal SE was less pronounced in patients with DM, while parameters of the diastolic function and its change with stress were almost insignificant. WMSI in comparison to GLS% didn’t make a difference in SE outcome regarding DM presence. WMSI was almost unchanged at maximal stress in diabetic patients. Conversely, GLS% showed significant worsening at maximal stress in diabetic patients. However, only WMSI at maximal stress along with DM presence appeared as independent predictors of the presence of new and worsening CAD during SE. Longitudinal strain assessed using speckle tracking during pharmacological stress echocardiography was superior to conventional echocardiography expressed by wall motion analysis in making a difference regarding DM presence.CONCLUSION:We confirmed the usefulness of stress echocardiography using qualitative and/or quantitative parameters in the detection of CAD in patients with DM.