Abstract
To quantify the global and regional left ventricular (LV) myocardial strain in type 2 diabetes mellitus (T2DM) patients using cardiac magnetic resonance (CMR) tissue-tracking techniques and to determine the ability of myocardial strain parameters to assessment the LV deformation. Our study included 98 adult T2DM patients (preserved LV ejection fraction [LVEF], 72; reduced LVEF, 26) and 35 healthy controls. Conventional LV function, volume-time curve parameters and LV remodeling index were measured using CMR. Global and regional LV myocardial strain parameters were measured using CMR tissue tracking and compared between the different sub-groups. Receiver operating characteristic analysis was used to assess the diagnostic accuracy. Regression analyses were conducted to determine the relationship between strain parameters and the LV remodeling index. The results show that global radial peak strain (PS) and circumferential PS were not significantly different between the preserved-LVEF group and control group (P > 0.05). However, longitudinal PS was significantly lower in the preserved-LVEF group than in the control group (P = 0.005). Multivariate linear and logistic regression analyses showed that global longitudinal PS was independently associated (β = 0.385, P < 0.001) with the LV remodeling index. In conclusion, early quantitative evaluation of cardiac deformation can be successfully performed using CMR tissue tracking in T2DM patients. In addition, global longitudinal PS can complement LVEF in the assessment of cardiac function.
Highlights
Type 2 diabetes mellitus (T2DM) is a metabolic disease associated with high morbidity
There were no significant differences in laboratory data between the preserved-left ventricular ejection fraction (LVEF) group and the reducedLVEF group
LVEF were lower in the type 2 diabetes mellitus (T2DM) patients as compared to the control group (59.14 ± 7.94% vs. 62.86 ± 3.63%, P < 0.001)
Summary
Type 2 diabetes mellitus (T2DM) is a metabolic disease associated with high morbidity. T2DM patients have been found to have different types of cardiovascular issues, such as increased oxidative stress, endothelial dysfunction, mitochondrial dysfunction, impaired calcium handling, and extracellular matrix remodeling[4]. These findings suggest that histological changes, LV remodeling, myocardial hypertrophy, and fibrosis occur, which may lead to cardiac diastolic dysfunction and eventually to systolic heart failure[4]. Traditional SSFP cine sequences (bFFE, TrueFISP, and FIESTA) are suitable for CMR tissue tracking and only require a relatively quick and easy post-processing approach making these sequences ideal for the quantitative evaluation of LV myocardial strain characteristics. We explore the relationship between myocardial strain parameters with LV remodeling index
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