Evaluation of Left Ventricular Function in Diabetic Patients: Insights from Dipyridamole-induced Heart Rate Variability and G-SPECT Imaging Techniques

Introduction: Left Ventricular Dysfunction (LVD) is a frequent complication in Diabe-tes mellitus (DM) patients, often worsened by cardiovascular disease. This study explores the role of dipyridamole (DP)-induced heart rate variability and G-SPECT imaging in evaluating LVD in DM patients. Aim: This study aimed to evaluate the relationship between heart rate ratio (HRR) during DP stress and LVD parameters derived from gated SPECT (G-SPECT) in DM patients, aiming to identify if HRR can serve as a marker for early LVD assessment. Methods: A cross-sectional study of 125 patients referred for cardiac scanning. Patients were grouped by diabetic status and HRR (≤ 1.2 vs. > 1.2) post-DP. G-SPECT-derived left ventricular parameters were compared between groups. Results: G-SPECT showed that peak filling rate (PFR) was higher in non-DM patients. In the HRR ≤ 1.2 group, DM patients had significantly higher end-diastolic volume (EDV) and end-systolic volume (ESV) than non-DM patients (EDV: 66.41±31 vs. 51.34±18, p-value:0.009; ESV: 27.88±11.21 vs. 18.63±15.5, p- p-value: 0.015). Discussion: This study evaluated the role of heart rate response during dipyridamole stress testing combined with G-SPECT imaging in assessing left ventricular dysfunction (LVD) in diabetic pa-tients. The findings indicate that changes in ventricular volume parameters, along with heart rate response, may serve as early markers of cardiac impairment, potentially facilitating earlier detec-tion and improved management of cardiac complications in this population. Conclusion: Reduced HRR during DP stress, combined with G-SPECT, may aid in the assessment of LVD in DM patients, potentially facilitating earlier diagnostic insights.