Evaluation of left ventricular systolic and diastolic function in subjects with prediabetes and diabetes using cardiovascular magnetic resonance-feature tracking

Zhou, Shanshan; Zhang, Zheng; Zhang, Zhen; Gao, Yiyuan; Li, Gengxiao; Lou, Mingwu; Zhao, Zhiwei; Zhao, Jun; Pohost, Gerald M.

doi:10.1007/s00592-021-01822-7

Cited by 9 publications

(10 citation statements)

References 38 publications

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“…The strength of the correlation between HbA1c and myocardial strain in this study, although statistically significant, was relatively low. Several studies showed that HbA1c was weakly to modestly correlated with myocardial strain in different study populations 26,31,32 . In prior studies evaluating the predictive value of myocardial strain, the small differences between event and event‐free groups contributed to LV adverse remodeling 12 and occurrence of major adverse cardiac events 33 .…”

Section: Discussionmentioning

confidence: 99%

“…Several studies showed that HbA1c was weakly to modestly correlated with myocardial strain in different study populations. 26,31,32 In prior studies evaluating the predictive value of myocardial strain, the small differences between event and event-free groups contributed to LV adverse remodeling 12 and occurrence of major adverse cardiac events. 33 In the subgroup analysis, HbA1c was not correlated with strain in patients with reduced ejection fraction.…”

Section: Discussionmentioning

confidence: 99%

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Glycemic Status and Myocardial Strain by Cardiac MRI in Patients With ST‐Segment Elevation Myocardial Infarction

Guo

et al. 2023

Magnetic Resonance Imaging

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BackgroundIt is uncertain how various degree of glycemic status affect left ventricular (LV) myocardial strain in ST‐segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI).PurposeTo investigate the relationship of glycemic status and myocardial strain in STEMI patients.Study TypeProspective cohort study.Population282 STEMI patients with cardiac magnetic resonance imaging 5 ± 2 days post‐PPCI. Patients were divided into three groups based on the level of glycated hemoglobin A1c (HbA1c) (group 1: HbA1c < 5.7%; group 2: 5.7% ≤ HbA1c < 6.5%; group 3: HbA1c ≥ 6.5%).Field Strength/Sequence3.0‐T; late gadolinium enhancement, balanced steady‐state free precession cine sequence, black blood fat‐suppressed T2‐weighted.AssessmentLV function, myocardial strain, and infarct characteristics (infarct size, microvascular obstruction, and intramyocardial hemorrhage) were compared among the three groups by one‐way analysis of variance (ANOVA) or Wilcoxon rank sum test. Intraobserver and interobserver reproducibility of LV myocardial strain was evaluated.Statistical TestsANOVA or Wilcoxon rank sum test, Pearson chi‐square or Fisher's exact test, Spearman's correlation analyses and multivariable linear regression analysis. A two‐tailed P value <0.05 was considered statistically significant.ResultsInfarct characteristics were similar among the three groups (P = 0.934, P = 0.097, P = 0.533, respectively). Patients with HbA1c ≥ 6.5% had decreased LV myocardial strain compared with HbA1c 5.7%–6.4%, as evidenced by global radial (GRS), global circumferential (GCS), and global longitudinal (GLS) strain. However, no significant differences in myocardial strain were observed between patients with HbA1c 5.7%–6.4% and HbA1c < 5.7% (P = 0.716; P = 0.294; P = 0.883, respectively). After adjustment for confounders, HbA1c as a continuous variable (beta coefficient [β] = −0.676; β = 0.172; β = 0.205, respectively) and HbA1c ≥ 6.5% (β = −3.682; β = 0.552; β = 0.681, respectively) were both independently associated with decreased GRS, GCS, and GLS.Data ConclusionPatients with uncontrolled blood glucose (categorized in group HbA1c ≥ 6.5%) had worse myocardial strain. The level of HbA1c appeared to be independently associated with decreased myocardial strain in STEMI patients.Level of Evidence2Technical Efficacy Stage2

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Glycemic Status and Myocardial Strain by Cardiac MRI in Patients With ST‐Segment Elevation Myocardial Infarction

Guo

et al. 2023

Magnetic Resonance Imaging

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“…Diastolic dysfunction has also been observed in prediabetes who do not have any risk factors for heart disease in humans [ 6 , 9 ] and rats [ 11 ]. Changes in LV diastolic function had been found to precede the onset of diabetes in another study [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…There seems to be a progressive increase in the risk of cardiovascular disease with increasing glucose intolerance levels before the diagnosis of diabetes mellitus [ 2 - 5 ]. Notably, diastolic dysfunction is frequent in prediabetes [ 6 ], and the diagnosis of diastolic dysfunction may give a way for identifying at-risk people, which may be a candidate for early and more aggressive intervention to avoid heart failure [ 7 ]. Although LV diastolic dysfunction can be clearly diagnosed by traditional testing methods, such as echocardiography, the earliest phase of LV dysfunction may be compensated by numerous mechanisms [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Left ventricular diastolic reserve by exercise stress echocardiography in prediabetes

Al-Gburi¹

2022

Tzu Chi Medical Journal

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A BSTRACT Objectives: The objective of this study was to evaluate if the diastolic reserve is different in prediabetes versus control during exercise. Materials and Methods: During the resting stage and graded supine bicycling exertion (25 W, 3 min increment), the mitral inflow and septal mitral annular velocities were determined in 50 patients with prediabetes (21 females, mean age 48 ± 16 years) and 50 gender- and age-matched controls. None demonstrated rest or inducible cardiac ischemia on echocardiography. Results: Between the two study groups, the velocities of the mitral inflow (E) and septal mitral annulus (E′) at rest are not significantly different. E′ during exercise, on the other hand, was significantly lower in individuals with prediabetes than in controls (8.57 ± 2.46 vs. 9.82 ± 2.42 cm/s at 25 W, P = 0.012; 9.42 ± 1.93 vs. 11.15±2.97 cm/s at 50 W, P = 0.001). E/E′ behaves oppositely during exercise with a value that is significantly higher in patients with prediabetes. Conclusion: The diastolic reserve of the left ventricle, as determined by the change in E′ and E/E′ throughout exercise, is abnormal in individuals with prediabetes who do not have overt cardiac disease. Using exercise stress echocardiography may be helpful for the early recognition of subclinical diastolic dysfunction in prediabetics which may have clinical repercussions in the future.

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Left ventricular longitudinal strain in patients with type 2 diabetes mellitus is independently associated with glycated hemoglobin level

Gao,

Xu,

Gong

et al. 2023

Clinical Cardiology

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ObjectiveLeft ventricular and left atrial strain are sensitive and reliable markers for evaluating cardiac function in patients with type 2 diabetes mellitus (T2DM), with interactions between the two parameters. The present study aimed to analyze the correlation between global longitudinal strain (GLS) of the left ventricle and glycated hemoglobin (HbA1c) levels in patients with T2DM.MethodsA total of 292 patients clinically diagnosed with T2DM were selected and divided into three groups according to HbA1c level. The strains of the left atrium and left ventricle in the three groups of T2DM patients with different HbA1c levels were compared. Univariate and multivariate (including left atrial functional indicators) linear regression analyses were performed to assess the relationship between strain indicators and HbA1c levels. Generalized additive models were used to examine the relationship between strain indicators and HbA1c levels.ResultsThere were significant differences among the three groups in terms of age, microalbuminuria, total cholesterol, fasting blood glucose, postprandial blood glucose, and HbA1c level, and left atrial conduit longitudinal strain (LAScd) and GLS (p < .05). Univariate and multivariate linear regression analyses revealed that, as HbA1c levels increased, the absolute value of GLS gradually decreased (p < .001). Curve fitting revealed a positive correlation between HbA1c level and GLS, which was not affected by left atrial function.ConclusionLeft ventricular GLS was independently correlated with HbA1c level in patients with T2DM and was not affected by left atrial function.

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Evaluation of left ventricular systolic and diastolic function in subjects with prediabetes and diabetes using cardiovascular magnetic resonance-feature tracking

Cited by 9 publications

References 38 publications

Glycemic Status and Myocardial Strain by Cardiac MRI in Patients With ST‐Segment Elevation Myocardial Infarction

Glycemic Status and Myocardial Strain by Cardiac MRI in Patients With ST‐Segment Elevation Myocardial Infarction

Left ventricular diastolic reserve by exercise stress echocardiography in prediabetes

Left ventricular longitudinal strain in patients with type 2 diabetes mellitus is independently associated with glycated hemoglobin level

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