HbA1c and Myocardial lschemia detected via Myocardial Perfusion Scintigraphy in type 2 Diabetes Mellitus

Background/Objective@#Coronary Artery Disease (CAD) is the leading cause of mortality among patients with type 2 diabetes mellitus. Several studies evaluated glycemic control and MPS resultswith good correlation. In the Philippines, data concerning this matter are few, hence this study.@*Methodology@#This is a cross-sectional study of selected Filipino patients with type 2 diabetes mellitus without previous cardiac events who underwent stress or pharmacologic stress MPS (TI-201 or Tc-99m sestamibi) over an 18-month period at the Philippine Heart Center. Electrocardiogram and 2D echocardiogram results were also noted. Patients were grouped into adequate glycemic control (HbA1c<7.0%) and inadequate glycemic control (HbA1c >7.0%). Binary logistic regression was computed to determine association of glycemic control to MPS defects. @*Results@#A total of 206 subjects (114 HBa1C <7.0%, 92 with HbA1c ? 7.0%), were included in the study; with male predominance. Mean HbA1c values showed direct correlation; the higher the HbA1c values, the more MPS defects. Inadequate glycemic control group had significanlty higher subjects with mild and moderate to severe degree of myocardial ischemia (p<0.001). the relative risk of having a significant CAD in the inadequate glycemic control group is 4.30 times more than their counterpart (p<0.001). Factoring the duration of inadequate glycemic control to > 10 years, relative risk increased to 7.63@*Conclusion@#The study shows that patients with type 2 diabetes mellitus with inadequate glycemic control have increased MPS defects and highter relative risk for having significant CAD. Diabetic patients with inadequate glycemic control for > 10 years have an even higher risk of having significant CAD.

Myocardial perfusion scintigraphy in transposition of the great arteries after an arterial switch operation in infants

An abnormal myocardial perfusion is not uncommon in congenital heart defects (CHD). Many case reports and prospective studies were done describing myocardial peOision scintigraphy (MPS)findings after an arterial switch operation (ASO) among transposition of the great arteries (TCA), but to the best of the authors' knowledge, none have cited MPS findings in the immediate post-operative petiod. This paper aims to show two ckfferent clinicalthuatiomts in which (MPS) was used in the assessment of myocarchalfiinction in TCA immediatelyfollowing an arterial switch operation. Two male infants; aged 2 months and 4 months; both diagnosed with transposition of the great arteries presenting with past-operative morbidities after an arterial switch operation were referred to the Department of Nuclear Medicine/or evaluation. The younger infant was ditty discharged improved with an earlier magical intervention in contrast to the other who expired Bothpatients revealed a scintigraphic picture of myocarcbal ischemia and left ventricular a54ifiniction with concomitant right ventricular hypertrophy MPS .findings and reflective clinical pictures of patients with corrected congenital disease are yet to be/illy elticidated,.from the expected natural course after the stag/Cal intervention and long term complications ofsuch cases. The two cases present an invaluable avenue of non-invasive diagnostic modality using-MPS to assess probable pathologic mechanisms that occur after an arterial switch operation, and perhaps suggest incremental value not only in the post-operative period but in the preoperative scenario in the prognostication of these patients.

Quantitative parameters in Tc-99m pertechnetate thyroid scintigraphy predict increased gland uptake function

BACKGROUND/OBJECTIVE: Direct measurement of gland uptake function is done by determining radioactive iodine uptake (RAID) values. Scintigraphic parameters in 99mTc0-4 thyroid scan have been shown to be moderately correlated with FT4 levels. This study aims to correlate these scintigrahic parameters with RAIU values and determine the cutoff that will predict increased gland uptake function.METHODOLOGY: Patients referred for thyroid scan and RAI uptake at the Philippine Heart Center were included in the study. RAW. values were correlated with thyroid salivary gland ratio, thyroid to background ratio, thyroid count and acquision time. These values were obtained by drawing appropriate regions of interest in the thyroid, salivary gland and the background.RESULTS: The four parameters were strongly correlated with RAI uptake values. The cut-off for the thyroid salivary gland ratio, thyroid to background ratio, total thyroid count and acquisition time that best predicts increased gland uptake were > 9.3, > 9.8, > 108134 counts, and CONCLUSION: The four scrim/graphic parameters can be used in determining the activity of the gland using thyroid imaging alone in the absence of RA1U values.