Evaluation of left ventricular function in patients with asymptomatic type 2 diabetes mellitus by cardiac cine magnetic resonance imaging

Abstract

Objective To evaluate left ventricular structure and function in patients with asymptomatic type 2 diabetes mellitus (T2DM) by cardiac cine magnetic resonance imaging (MRI). Methods Sequential left ventricular short-axis cine MRI was acquired on 85 diabetic out-patients (T2DM group) and 43 normal health controls (control group) from November 2005 to January 2006. Parameters of resting left ventricular diastolic and systolic function and hemodynamics were analyzed and compared between the two groups, including end diastole volume index (EDVI), end systole volume index (ESVI), stroke volume index (SVI), cardiac index (CI), eject fraction (EF), wall thickness of end diastole (WTED), wall thickness of end systole (WTES), thickening (TN), wall motion (WM), body surface area (BSA), peak ejecting rate (PER), time of peak ejecting (TPE), peak filling rate (PFR) and time of peak filling (TPF). Two-tailed independent-samples t test, χ2 test, and multiple logistic regression were used for data analysis. Results In the T2DM group, ESVI was lower than the control group ((22±8) vs (25±5) ml/m2,t=2.265, P<0.05); however, EF was higher than the control group (59%±9% vs 56%±6%, t=-2.457, P<0.05). Left ventricular wall thickness was increased than the control group, and PFR was decreased ((282±73) vs (321±99) ml/s, t=2.508, P<0.05). Multiple logistic regression model showed that hyperglycemia was the most important factor of left ventricle dysfunction (χ2=3.781, P=0.052). Conclusions Cardiac cine MRI is considered the gold standard for evaluating left ventricular function. Diabetic cardiomyopathy, manifested by diastolic dysfunction followed by abnormalities in systolic function, is common in type 2 diabetic patients without apparent cardiocomplications. Hyperglycemia may be the most important factor of diabetic cardiomyopathy. Key words: Cine magnetic resonance imaging; Type 2 diabetes mellitus; Left ventricular functions