The right ventricular dysfunction and ventricular interdependence in patients with DM: assessment using cardiac MR feature tracking

Shi, Rui; Yang, Zhi-Gang; Guo, Yingkun; Qian, Wen-Lei; Gao, Yue; Li, Xueming; Jiang, Li; Xu, Huayan; Li, Yuan

doi:10.1186/s12933-023-01806-7

Cited by 6 publications

(4 citation statements)

References 39 publications

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“…Several studies have revealed that the T2DM group had a signi cantly lower RV GLS than the control group. Further, RV dysfunction was an important component of diabetic cardiomyopathy [10,17]. In the current study, the T2DM (AR−) group had a low RV global and regional longitudinal strain.…”

Section: Rv Dysfunction and Pathophysiological Mechanisms In T2dmmentioning

confidence: 52%

“…Due to the predominance of longitudinal subendocardial myocytes, longitudinal shortening accounts for approximately 75% of RV contractions [20,21]. Therefore, the RV longitudinal strain was a good indicator of RV dysfunction and good reproducibility in patients with diabetes combined with circumferential strain [10,22,23]. Further, another study found that the deterioration of RV performance was observed in the basal and apical segments of the RV free wall in asymptomatic patients with diabetes [19].…”

Section: Rv Dysfunction and Pathophysiological Mechanisms In T2dmmentioning

confidence: 99%

“…These conditions can cause cardiovascular-related mortality [8,9]. Notably, RV impairment can be a component of ventricular interdependence in diabetic cardiomyopathy [10]. Therefore, the synergistic effects of T2DM and AR on ventricular interdependence should be evaluated.…”

Section: Introductionmentioning

confidence: 99%

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The right ventricular dysfunction and ventricular interdependence in patients with T2DM and aortic regurgitation: an assessment using CMR feature tracking

Shen,

Shi,

Yang

et al. 2024

Preprint

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Background Patients with concomitant type 2 diabetes mellitus (T2DM) and aortic regurgitation (AR) can present with right ventricular (RV) dysfunction. The current study aimed to evaluate the impact of AR on RV impairment and the importance of ventricular interdependence using cardiac magnetic resonance feature tracking (CMR‑FT) in patients with T2DM. Methods This study included 229 patients with T2DM (AR−), 88 patients with T2DM (AR+), and 122 healthy controls. The biventricular global radial strain (GRS), global circumferential strain (GCS), and global longitudinal peak strain (GLS) were calculated with CMR‑FT and compared among the healthy control, T2DM (AR−), and T2DM (AR+) groups. The RV regional strains at the basal, mid, and apical cavities between the T2DM (AR+) group and subgroups with different AR degrees were compared. Backward stepwise multivariate linear regression analyses were performed to determine the effects of AR and left ventricular (LV) strains on RV strains. Results The RV GLS, LV GRS, LV GCS, LV GLS, interventricular septal (IVS) GRS and IVS GCS were decreased gradually from the controls through the T2DM (AR−) group to the T2DM (AR+) group. The IVS GLS of the T2DM (AR−) and T2DM (AR+) groups was lower than that of the control group. AR was independently associated with LV GRS, LV GCS, LV GLS, RV GCS, and RV GLS. If AR and LV GLSs were included in the regression analyses, AR and LV GLS were independently associated with RV GLS. Conclusion AR can exacerbate RV dysfunction in patients with T2DM, which may be associated with the superimposed strain injury of the left ventricle and interventricular septum. The RV longitudinal and circumferential strains are important indicators of cardiac injury in T2DM and AR. The unfavorable LV-RV interdependence supports that while focusing on improving LV function, RV dysfunction should be monitored and treated in order to slow the progression of the disease and the onset of adverse outcomes.

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Section: Rv Dysfunction and Pathophysiological Mechanisms In T2dmmentioning

confidence: 52%

Section: Rv Dysfunction and Pathophysiological Mechanisms In T2dmmentioning

confidence: 99%

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The right ventricular dysfunction and ventricular interdependence in patients with T2DM and aortic regurgitation: an assessment using CMR feature tracking

Shen,

Shi,

Yang

et al. 2024

Preprint

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“…This finding is in line with the disparities observed in RVGCS and RVGLS among individuals with PH in the RVEF ≥ 50% category compared with controls in a study by de Siqueira et al 22 Advances in MRI technology have enabled cardiologists to use MRI-FT-derived myocardial strain as a means of early and sensitive detection of RV dysfunction across various disease profiles. 23,24 Studies have demonstrated that RV function serves as a significant prognostic indicator for patients with PH. 3,25 Furthermore, several studies have reported the correlation between myocardial strain parameters and the prognosis of patients with PH.…”

Section: Discussionmentioning

confidence: 99%

Biventricular Dysfunction and Ventricular Interdependence in Patients With Pulmonary Hypertension: A 3.0‐T Cardiac MRI Feature Tracking Study

Fang,

Wang,

Shi

et al. 2023

Magnetic Resonance Imaging

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BackgroundPulmonary hypertension (PH) results in right ventricular (RV) dysfunction, subsequently leading to left ventricular (LV) impairment. The mechanism underlying ventricular interdependence is largely uninvestigated.PurposeTo explore the biventricular dysfunction and the ventricular interdependence in PH patients.Study TypeRetrospective.PopulationOne hundred and seven PH patients (mean pulmonary artery pressure >20 mmHg) and 72 age‐ and sex‐matched controls with cardiac magnetic resonance imaging (MRI) studies.Field Strength/Sequence3.0 T/balanced steady‐state free precession sequence.AssessmentLV and RV ejection fractions (EF) and RV and LV radial, circumferential, and longitudinal strains were assessed using commercial software. Strains were compared between controls, PH patients with preserved RVEF (RVEF ≥40%, N = 48), and PH patients with reduced RVEF (RVEF <40%, N = 59).Statistical TestsChi‐squared tests or Fisher's exact test, t tests or Mann–Whitney U test, one‐way ANOVA with Bonferroni's post hoc correction or Kruskal–Wallis test, Pearson or Spearman correlation, and multivariable linear regression analysis. A two‐tailed P < 0.05 was deemed statistically significant.ResultsRV strain decreased sequentially from controls, through PH with preserved RVEF, to PH with reduced RVEF. PH patients with reduced RVEF had significantly lower LV strain, especially septal strain, and LV peak diastolic strain rate compared with both controls and PH patients with preserved RVEF. Multivariable analyses showed that RVEF was independently correlated with LV strain; furthermore, independent of RVEF, RV strain was significantly correlated with LV strain (LVGRS: β = 0.416; LVGCS: β = −0.371; LVGLS: β = 0.283).Data ConclusionSubclinical impairment of RV function was found in PH with preserved RVEF. LV strain was impaired when RV was dysfunctional, which was associated with worsening RV strain. Therefore, while focusing on improving RV function, LV dysfunction in PH patients should also be monitored and treated early in order to slow the progression of the disease.Level of Evidence3Technical EfficacyStage 3

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Biventricular Impairment and Ventricular Interdependence in Patients With Alcoholic Cardiomyopathy: Insights Through Cardiac Magnetic Resonance Imaging

Wang,

Yang,

Fang

et al. 2024

Magnetic Resonance Imaging

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BackgroundAlcoholic cardiomyopathy (ACM) can lead to progressive cardiac dysfunction and heart failure, but little is known about biventricular impairment and ventricular interdependence (VI) in ACM patients.PurposeTo use cardiac MRI to investigate biventricular impairment and VI in ACM patients.Study TypeRetrospective.PopulationForty‐one male patients with ACM and 45 sex‐ and age‐matched controls.Field Strength/Sequence3.0 T/balanced steady‐state free precession sequence, inversion recovery prepared echo‐planar imaging sequence and phase‐sensitive inversion recovery sequence.AssessmentBiventricular structure, function, and global strain (encompassing peak strain [PS], peak systolic, and diastolic strain rate), PS of interventricular septal (IVS), microvascular perfusion (including upslope and time to maximum signal intensity [TTM]), late gadolinium enhancement (LGE), and baseline characteristics were compared between the controls and ACM patients.Statistical TestsStudent's t‐test, Mann–Whitney U test, Pearson's correlation, and multivariable linear regression models with a stepwise selection procedure. A two‐tailed P value <0.05 was deemed as statistically significant.ResultsCompared to control subjects, ACM patients showed significantly biventricular adverse remodeling, reduced left ventricle (LV) global upslope and prolonged global TTM, and the presence of LGE. ACM patients were characterized by a significant decline in all global strain within the LV, right ventricle (RV), and IVS compared with the controls. RV global PS was significantly associated with LV global PS and IVS PS in radial, circumferential, and longitudinal directions. Multivariable analyses demonstrated the longitudinal PS of IVS was significantly correlated with RV global radial PS (β = 0.614) and circumferential PS (β = 0.545). Additionally, RV global longitudinal PS (GLPS) was significantly associated with radial PS of IVS (β = −0.631) and LV GLPS (β = 1.096).Data ConclusionACM patients exhibited biventricular adverse structural alterations and impaired systolic and diastolic function. This cohort also showed reduced LV microvascular perfusion, the presence of LGE, and unfavorable VI.Evidence Level3Technical EfficacyStage 3

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The right ventricular dysfunction and ventricular interdependence in patients with DM: assessment using cardiac MR feature tracking

Cited by 6 publications

References 39 publications

The right ventricular dysfunction and ventricular interdependence in patients with T2DM and aortic regurgitation: an assessment using CMR feature tracking

The right ventricular dysfunction and ventricular interdependence in patients with T2DM and aortic regurgitation: an assessment using CMR feature tracking

Biventricular Dysfunction and Ventricular Interdependence in Patients With Pulmonary Hypertension: A 3.0‐T Cardiac MRI Feature Tracking Study

Biventricular Impairment and Ventricular Interdependence in Patients With Alcoholic Cardiomyopathy: Insights Through Cardiac Magnetic Resonance Imaging

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