Abstract
Background Patients with diabetes mellitus (DM) are known to have microvascular coronary artery disease (CAD), in the absence of hypertension and flow limiting stenoses on epicardial coronary arteries. Microvascular coronary dysfunction can be detected on CMR using adenosine stress perfusion imaging. Native T1 values can detect tissue water content of intra/extracellular or intra/extravascular origin. We hypothesised that increased myocardial blood volume in the intravascular space under adenosine vasodilator stress will have a measurable effect on T1 values. Therefore, we compared adenosine stress T1 response and myocardial perfusion reserve in patients with type-2 DM (T2DM) without macrovascular CAD against controls.
Highlights
Patients with diabetes mellitus (DM) are known to have microvascular coronary artery disease (CAD), in the absence of hypertension and flow limiting stenoses on epicardial coronary arteries
Microvascular coronary dysfunction can be detected on CMR using adenosine stress perfusion imaging
Increases in rate pressure product were similar in patients and controls (T2DM 40±3%, controls 39±3%, p=0.89)
Summary
Adenosine stress native T1 mapping detects microvascular disease in diabetic cardiomyopathy, without the need for gadolinium-based contrast. Eylem Levelt1,2*, Stefan K Piechnik, Masliza Mahmod, Vanessa M Ferreira, Rina Ariga, Jane M Francis, Alexander Liu, Joanne Sellwood, Rohan S Wijesurendra, Matthew D Robson, Kieran Clarke, Stefan Neubauer, Theodoros D Karamitsos
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