The combined effects of cardiac geometry, microcirculation, and tissue characteristics on cardiac systolic and diastolic function in subclinical diabetes mellitus-related cardiomyopathy
The combined effects of cardiac geometry, microcirculation, and tissue characteristics on cardiac systolic and diastolic function in subclinical diabetes mellitus-related cardiomyopathy
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心脏几何形状、微循环和组织特征对亚临床糖尿病相关心肌病心脏收缩和舒张功能的综合影响
DOI：
10.1016/j.ijcard.2020.07.013
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发表时间：
2020-12-01
影响因子：
3.5
通讯作者：
Yang, Zhi-gang
中科院分区：
文献类型：
--
作者：
Jiang, Li;Wang, Jin;Yang, Zhi-gang
背景资料：糖尿病相关心肌病最近被描述为左心室（LV）收缩和舒张功能障碍的明显进展。心肌的病理变化可以解释两种不同表型的发展。我们评估了左室几何形状，心肌微循环，心脏变形的亚临床2型糖尿病（T2 DM）患者利用多参数心脏磁共振成像（CMR）imaging.Methods：共135 T2 DM患者和55匹配的对照组前瞻性入组，并进行多参数CMR检查的组织特征的影响。分析并比较T2 DM患者和对照组的CMR衍生参数，包括心脏几何结构、功能、微血管灌注、T1标测、T2标测和应变。收缩和舒张功能的单变量和多变量分析显示，糖尿病病程越长，纵向峰值收缩应变率（PSSR-L）越低（β = 0.195，p = 0.013），更高的重塑指数和更高的细胞外容积（ECV）往往与纵向峰值舒张应变率（PDSR-L）降低相关（重塑指数，β =-0.339，p = .000; ECV，β =-0.172，p = 0.026），而微血管灌注指数和T2值影响PSSR-L（灌注指数，β =-0.328，p = .000; T2值，β = 0.306，p = .000）和PDSR-L（灌注指数，β = 0.209，p = 0.004; T2值，β =-0.275，p = 0.000）。左室向心性重构和心肌纤维化与左室舒张功能相关，灌注功能和心肌水肿与左室收缩和舒张功能均相关。(C)2020作者由爱思唯尔公司出版
Background: Diabetes mellitus-related cardiomyopathy has recently been described as a distinct progression of left ventricular (LV) systolic and diastolic dysfunction. Pathological changes in the myocardium may explain the development of two different phenotypes. We evaluated the effects of LV geometry, myocardial microcirculation, and tissue characteristics on cardiac deformation in patients with subclinical type 2 diabetes mellitus (T2DM) utilizing multiparametric cardiac magnetic resonance (CMR) imaging.Methods: A total of 135 T2DM patients and 55 matched controls were prospectively enrolled and performed multiparametric CMR examination. CMR-derived parameters including cardiac geometry, function, microvascular perfusion, T1 mapping, T2 mapping, and strain were analyzed and compared between T2DM patients and controls.Results: The univariable and multivariable analysis of systolic and diastolic function revealed that longer duration of diabetes was associated with decreased longitudinal peak systolic strain rate (PSSR-L) (beta = 0.195, p = .013), and higher remodeling index and higher extracellular volume (ECV) tended to correlate with decreased longitudinal peak diastolic strain rate (PDSR-L) (remodeling index, beta = -0.339, p = .000; ECV, beta = -0.172, p = .026), whereas microvascular perfusion index and T2 value affected both PSSR-L (perfusion index, beta = -0.328, p = .000; T2 value, beta = 0.306, p = .000) and PDSR-L (perfusion index, beta = 0.209, p = .004; T2 value, beta = -0.275, p = .000) simultaneously.Conclusions: The LV concentric remodeling and myocardial fibrosis correlated with diastolic function, and perfusion function and myocardial edema were associated with both LV systolic and diastolic function. (C) 2020 The Authors. Published by Elsevier B.V.