Key result
Type 2 diabetes was not associated with a significant temporal change in myocardial flow reserve over 6 years compared to healthy controls (mean difference -0.10, 95% CI -0.52 to 0.31).
Why the study?
Knowledge regarding changes in myocardial microvascular function over time is lacking.
Does type 2 diabetes accelerate the temporal decline in myocardial microvascular function compared to healthy controls over 6 years?
Cohort (n=48)
Does type 2 diabetes accelerate the temporal decline in myocardial microvascular function compared to healthy controls over 6 years?
Mean Difference: -0.1 (95% CI -0.52–0.31)
Absolute Event Rate: -0.22% vs -0.12%
p-value: p=0.64
Myocardial microvascular function is impaired in persons with type 2 diabetes compared to healthy controls but does not show significant temporal decline over a 6-year period.
Stable MFR over 6 years in type 2 diabetes suggests no rapid microvascular decline; leaves open longer-term progression and intervention needs.
Background Cardiac Rubidium‐82 (82Rb) positron emission tomography/computed tomography (PET/CT) provides a measure of the myocardial blood flow and the myocardial flow reserve, which reflects the function of both large epicardial arteries and the myocardial microcirculation. Knowledge on changes in the myocardial microvascular function over time is lacking. Methods In this cohort study, we recruited 60 persons with type 2 diabetes and 30 non‐diabetic controls, in 2013; all free of overt cardiovascular disease. All underwent a cardiac 82Rb PET/CT scan. In 2019, all survivors (n = 82) were invited for a repeated cardiac 82Rb PET/CT scan using the same protocol, and 29 with type 2 diabetes and 19 controls participated. Results Median duration between visits was 6.2 years (IQR: 6.1–6.3). In the total cohort, the mean age was 66.4 years (SD: 9.3) and 33% were females. The myocardial flow reserve was lower in persons with type 2 diabetes compared to controls (p = 0.002) but there was no temporal change in the myocardial flow reserve in participants with type 2 diabetes: mean change: −0.22 (95% CI: −0.47 to 0.02) nor in controls: −0.12 (−0.49 to 0.25) or when comparing type 2 diabetes to controls: mean difference: −0.10 (95% CI: −0.52 to 0.31). The temporal reduction in stress‐induced myocardial blood flow did not differ within the groups but was more pronounced in type 2 diabetes compared to controls: mean difference: −0.30 (95% CI: −0.55 to −0.04). Conclusion The myocardial microvascular function was impaired in persons with type 2 diabetes compared to controls but did not change significantly in either of the groups when evaluated over 6 years.
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Rasmussen et al. (2021) conducted a cohort in Type 2 diabetes (n=48). Type 2 diabetes vs. Healthy controls was evaluated on Temporal change in myocardial flow reserve (MFR) (MD -0.10, 95% CI -0.52 to 0.31, p=0.64). Type 2 diabetes was not associated with a significant temporal change in myocardial flow reserve over 6 years compared to healthy controls (mean difference -0.10, 95% CI -0.52 to 0.31).
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