Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: a contrast-enhanced cardiovascular magnetic resonance study.
Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: a contrast-enhanced cardiovascular magnetic resonance study.
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无并发症的 2 型糖尿病患者的左心室亚临床心肌功能障碍与心肌灌注受损相关：对比增强心血管磁共振研究
DOI：
10.1186/s12933-018-0782-0
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发表时间：
2018-10-30
影响因子：
9.3
通讯作者：
Guo YK
中科院分区：
文献类型：
--
作者：
Liu X;Yang ZG;Gao Y;Xie LJ;Jiang L;Hu BY;Diao KY;Shi K;Xu HY;Shen MT;Ren Y;Guo YK
背景糖尿病（DM）患者亚临床心肌功能不全的早期检测对于推荐预防或逆转心力衰竭的治疗干预措施，从而改善此类患者的预后至关重要。本研究的目的是定量评价左心室（LV）心肌变形和灌注使用心血管磁共振（CMR）成像在2型糖尿病（T2 DM）患者，并探讨LV亚临床心肌功能障碍和冠状动脉微血管perfusion.MethodsWe招募了71 T2 DM患者和30名健康人作为对照组进行CMR检查。将T2 DM患者分为两组，即新诊断DM组（n= 31，糖尿病≤ 5年）和长期DM组（n= 40，糖尿病> 5年）。测量并比较3组左室变形参数，包括整体峰值应变（PS）、收缩期峰值应变率（PS）和舒张期峰值应变率（PSDR），以及心肌灌注参数，包括上升斜率、最大信号强度时间（TTM）和最大信号强度（Max SI）。皮尔逊相关性被用来评估左心室变形和灌注parameters. ResultsPool数据从T2 DM患者的相关性显示，全球纵向，圆周和径向PDSR相比，健康人，除了从较低的上坡。此外，与正常受试者相比，在长期糖尿病患者中发现TTM增加和Max SI减少（所有p< 0.017）。多元线性回归分析显示，除TTM外，T2 DM与CMR参数独立相关（β= 0.137，p = 0.195）。此外，纵向PDSR与上坡显著相关，（r=-0.346，p = 0.003）和TTM结论3.0TCMR增强扫描可检测T2 DM早期亚临床心肌功能障碍和心肌微血管灌注受损，心肌功能障碍与冠状动脉微血管灌注受损有关。
BackgroundEarly detection of subclinical myocardial dysfunction in patients with diabetes mellitus (DM) is essential for recommending therapeutic interventions that can prevent or reverse heart failure, thereby improving the prognosis in such patients. This study aims to quantitatively evaluate left ventricular (LV) myocardial deformation and perfusion using cardiovascular magnetic resonance (CMR) imaging in patients with type 2 diabetes mellitus (T2DM), and to investigate the association between LV subclinical myocardial dysfunction and coronary microvascular perfusion.MethodsWe recruited 71 T2DM patients and 30 healthy individuals as controls who underwent CMR examination. The T2DM patients were subdivided into two groups, namely the newly diagnosed DM group (n= 31, patients with diabetes for ≤ 5 years) and longer-term DM group (n= 40, patients with diabetes > 5 years). LV deformation parameters, including global peak strain (PS), peak systolic strain rate, and peak diastolic strain rate (PSDR), and myocardial perfusion parameters such as upslope, time to maximum signal intensity (TTM), and max signal intensity (Max SI, were measured and compared among the three groups. Pearson’s correlation was used to evaluate the correlation between LV deformation and perfusion parameters.ResultsPooled data from T2DM patients showed a decrease in global longitudinal, circumferential, and radial PDSR compared to healthy individuals, apart from lower upslope. In addition, increased TTM and reduced Max SI were found in the longer-term diabetics compared to the normal subjects (p< 0.017 for all). Multivariable linear regression analysis showed that T2DM was independently associated with statistically significant CMR parameters, except for TTM (β= 0.137,p= 0.195). Further, longitudinal PDSR was significantly associated with upslope (r= − 0.346,p= 0.003) and TTM (r= 0.515,p< 0.001).ConclusionsOur results imply that a contrast-enhanced 3.0T CMR can detect subclinical myocardial dysfunction and impaired myocardial microvascular perfusion in the early stages of T2DM, and that the myocardial dysfunction is associated with impaired coronary microvascular perfusion.
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影响因子：
14
作者：
Sacre, Julian W.;Franjic, Bennett;Marwick, Thomas H.
通讯作者：
Marwick, Thomas H.
影响因子：
2.8
作者：
Ng, Arnold C. T.;Delgado, Victoria;Bax, Jeroen J.
通讯作者：
Bax, Jeroen J.
DOI：
10.1093/ehjci/jeu142
发表时间：
2014-12
期刊：
European heart journal. Cardiovascular Imaging
影响因子：
--
作者：
Larghat AM;Swoboda PP;Biglands JD;Kearney MT;Greenwood JP;Plein S
通讯作者：
Plein S
DOI：
10.1007/s10554-017-1199-7
发表时间：
2017-12
期刊：
The international journal of cardiovascular imaging
影响因子：
--
作者：
Satriano A;Heydari B;Narous M;Exner DV;Mikami Y;Attwood MM;Tyberg JV;Lydell CP;Howarth AG;Fine NM;White JA
通讯作者：
White JA
DOI：
10.1016/s0735-1097(03)00941-0
发表时间：
2003-11-05
影响因子：
24
作者：
Maron, Barry J.;McKenna, William J.;Wigle, E. Douglas
通讯作者：
Wigle, E. Douglas