Abstract
BackgroundPrevious studies have found that impaired global myocardial systolic strain is associated with cardiovascular events in T2DM patients. However, the effect of hypertension (HT) on left atrial (LA), right ventricular (RV) and left ventricular (LV) myocardial deformation in hypertensive T2DM patients has not been fully studied by cardiac magnetic resonance feature tracking (CMR-FT). Our aim was to assess LA, RV and LV strain in T2DM patients with T2DM-HT and without hypertension using CMR-FT and to determine the underlying relationships with clinical parameters.MethodsA total of 27 T2DM patients, 23 T2DM-HT patients and 31 controls were studied. LA, LV and RV strain was evaluated using CMR-FT. The clinical and biochemical parameters of the patients were collected.ResultsThe T2DM patients had reduced LA global circumferential strain (LAGCS), radial strain (LAGRS), longitudinal strain (LAGLS) and right ventricular longitudinal strain (RVGLS) compared with the controls (LAGCS: 27.2 ± 2.1% vs 33.5 ± 2.4%; LAGRS: − 28.6 ± 1.1% vs − 31.9 ± 1.3%; LAGLS: 24.3 ± 1.3% vs 31.4 ± 1.5; RVGLS: − 21.4 ± 1.2% vs − 26.3 ± 1.1%, p < 0.05 for all). The T2DM-HT patients had greater LAGCS, LAGRS and LAGLS than the T2DM patients (LAGCS: 40.4 ± 3.8% vs 27.2 ± 2.1%; LAGRS: − 36.8 ± 2.0% vs − 28.6 ± 1.1%; LAGLS: 32.3 ± 2.4% vs 24.3 ± 1.3%, p < 0.05 for all). In the diabetic patients, LAGCS was associated with microalbuminuria levels (standardized ß = − 0.289, p = 0.021), and LAGCS, LAGRS and LAGLS were correlated with diuretic treatment (standardized ß =0.440, − 0.442, and 0.643, p < 0.05 for all).ConclusionsCMR-FT may be considered a promising tool for the early detection of abnormal LA and RV myocardial strain. LA and RV strain values are impaired in T2DM patients. The amelioration of LA strain might be associated with hypertensive compensation or antihypertensive treatment, which requires to be confirmed in larger trials.
Highlights
Previous studies have found that impaired global myocardial systolic strain is associated with cardiovascular events in type 2 diabetes mellitus (T2DM) patients
No significant differences in Hemoglobin A1c (HbA1c), microalbuminuria (MA), medications, serum glucose, fasting blood samples, diabetes duration, creatinine, TG, total cholesterol (TC), blood urea nitrogen (BUN), high-density lipoprotein cholesterol (HDL-C) or lowdensity lipoprotein cholesterol (LDL-C) were observed
Intra-observer and inter-observer reproducibility The intraclass correlation coefficient (ICC) values in the intraobserver analysis were 0.987, 0.810, 0.981, 0.985, 0.923, 0.916 and 0.877 for Left ventricular global radial strain (LVGRS), LV global circumferential strain (LVGCS), LV global longitudinal strain (LVGLS), Discussion Our findings suggest that (1) compared to the control group, the T2DM group had significantly deteriorated left atrial (LA) and right ventricular (RV) strain, and the amelioration of LA strain in Left ventricular end-diastolic volume (LVEDV) index
Summary
Previous studies have found that impaired global myocardial systolic strain is associated with cardiovascular events in T2DM patients. The effect of hypertension (HT) on left atrial (LA), right ventricular (RV) and left ventricular (LV) myocardial deformation in hypertensive T2DM patients has not been fully studied by cardiac magnetic resonance feature tracking (CMR-FT). Hypertension (HT) is a common concomitant condition in the majority of T2DM patients, and its coexistence contributes to a four-fold increased risk of cardiovascular mortality compared with normal controls [3]. These two conditions are associated with structural and functional atrioventricular abnormalities. Analyses of the role of LA and RV deformation in DCM by CMR-FT, especially with coexisting hypertension, have rarely been reported
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