Assessment of Diabetic Cardiomyopathy by Cardiovascular Magnetic Resonance T1 Mapping: Correlation with Left-Ventricular Diastolic Dysfunction and Diabetic Duration

Abstract

Purpose To quantify extracellular matrix expansion with the cardiovascular magnetic resonance (CMR) T1 mapping technique and the derived extracellular volume fraction (ECV) in diabetic cardiomyopathy (DbCM) patients and to detect the relationship among ECV, duration of diabetes, and diastolic function. Materials Thirty-eight patients with diabetic cardiomyopathy (20 males, age 54.6 ± 8.6 years) and thirty-two matched normal controls (15 males, age 51.4 ± 13.6 years) were prospectively enrolled. All of them were scanned by T1 mapping to obtain the native and postcontrast T1 values of myocardium and blood, and ECV was calculated accordingly. All patients also underwent transthoracic echocardiographic tissue Doppler imaging to assess left-ventricular diastolic function. Results There was a significant difference in ECV between the two groups (DbCMs 30.4 ± 2.9% versus controls 27.1 ± 2.4%, P < 0.001). The duration of diabetes was positively and strongly associated with ECV (R = 0.539, P = 0.0005). There was also a significant difference in ECV (P ≤ 0.001) among four groups (A, controls; B, DbCM patients with duration of diabetes <5 years; C, 5–10 years; and D, >10 years). ECV was negatively associated with LV E'/A' (R = −0.403, P = 0.012). Conclusion CMR T1 mapping can reflect myocardial extracellular matrix expansion in DbCM and can be a powerful technique for the early diagnosis of DbCM.

MRI and CT coronary angiography in survivors of COVID-19

“…An inflammatory cardiomyopathy has previously been linked with several viruses including influenza 28 but its association with COVID-19 remains unclear. Moreover, similar patterns of non-ischaemic late gadolinium enhancement are commonly observed in patients with hypertension and diabetes mellitus 27 in the absence of myocarditis. Regardless of the mechanism, the prognostic value of late gadolinium enhancement across multiple disease states probably warrants long-term follow-up.…”

Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: a contrast-enhanced cardiovascular magnetic resonance study

“…Thus, the final study cohort comprised 71 T2DM patients and 30 healthy controls (proportion of males 56.7% vs. 57.7%, p = 0.92; mean age 53.99 ± 11.15 vs. 53.23 ± 8.59 years, p = 0.74). Based on the duration of diabetes [ 7 , 20 ], all T2DM patients were categorized as either newly diagnosed DM (duration of diabetes ≤ 5 years, n = 31) or longer-term DM (duration of diabetes > 5 years, n = 41). The baseline characteristics of the T2DM patients and healthy volunteers are presented in Table 1 .…”

Extracellular volume fraction measurements derived from the longitudinal relaxation of blood-based synthetic hematocrit may lead to clinical errors in 3 T cardiovascular magnetic resonance

“…While some conditions such as myocardial infarction, cardiac amyloid, and HCM with LGE show a significant increase in the ECV [ 19 , 20 ], more subtle differences are seen in conditions with less myocardial damage, such as T2DM or HCM without LGE. Wong’s study [ 6 ] and our previous study [ 21 ] demonstrated that T2DM patients had a slightly but significant increased ECV. In the present study, there were minor but significant differences in the ECVm between the T2DM patients and the healthy subjects; however, the ECVsyn did not differ.…”