The worsening effect of anemia on left ventricular function and global strain in type 2 diabetes mellitus patients: a 3.0 T CMR feature tracking study

Qian, Wen-Lei; Xu, Rong; Shi, Rui; Li, Yuan; Guo, Yingkun; Han, Fang; Jiang, Li; Yang, Zhi‐gang

doi:10.1186/s12933-023-01745-3

Cited by 7 publications

(4 citation statements)

References 35 publications

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“…Kamruzzaman found that underweight women were more likely to be anemic ( 74 ). In addition, anemia has been shown to have a cumulative additive effect on left ventricular function and global strain in patients with type 2 DM ( 75 ). Furthermore, anemia is a common comorbidity in patients with heart failure, and is associated with poor outcomes ( 76 ).…”

Section: Discussionmentioning

confidence: 99%

Inter-relationships of risk factors and pathways associated with all-cause mortality in patients with chronic schizophrenia

Yu,

Lee,

Hsuan

et al. 2024

Front. Psychiatry

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IntroductionOf all psychiatric disorders, schizophrenia is associated with the highest risk of all-cause mortality. This study aimed to investigate independent risk factors for all-cause mortality in patients with chronic schizophrenia. In addition, the possible causal inter-relationships among these independent risk factors and all-cause mortality were also explored.MethodsWe conducted an analysis of 1,126 patients with chronic schizophrenia from our psychiatric department from April 2003 to August 2022, and retrospectively reviewed their medical records. The study endpoint was all-cause mortality. Baseline clinical characteristics including sociodemographic data, biochemical data, lifestyle factors, comorbidities and antipsychotic treatment were examined with Cox proportional hazards analysis.ResultsThe all-cause mortality rate was 3.9% (44 patients). Multivariate Cox regression analysis revealed that several factors were independently associated with all-cause mortality, including diabetes mellitus (DM), hypertension, heart failure, gastroesophageal reflux disease (GERD), peptic ulcer disease, ileus, underweight, fasting glucose, triglycerides, albumin, and hemoglobin. Structural equation modeling (SEM) analysis revealed that several factors had statistically significant direct effects on all-cause mortality. Heart failure, hypertension, underweight, age at onset, and ileus showed positive direct effects, while albumin and hemoglobin demonstrated negative direct effects. In addition, several factors had indirect effects on all-cause mortality. GERD indirectly affected all-cause mortality through ileus, and peptic ulcer disease had indirect effects through albumin and ileus. Ileus, underweight, DM, and hypertension also exhibited indirect effects through various pathways involving albumin, hemoglobin, and heart failure. Overall, the final model, which included these factors, explained 13% of the variability in all-cause mortality.DiscussionThese results collectively suggest that the presence of DM, hypertension, heart failure, GERD, peptic ulcer disease, ileus, and underweight, along with lower levels of albumin or hemoglobin, were independently associated with all-cause mortality. The SEM analysis further revealed potential causal pathways and inter-relationships among these risk factors contributing to all-cause mortality in patients with chronic schizophrenia.

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Section: Discussionmentioning

confidence: 99%

Inter-relationships of risk factors and pathways associated with all-cause mortality in patients with chronic schizophrenia

Yu,

Lee,

Hsuan

et al. 2024

Front. Psychiatry

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“…Moreover, our study also suggests an independent association between LA strain and LV diastolic function. In the absence of valvular heart disease, the LA and LV functions and lling pressures are tightly coupled during diastole since they are directly connected [35]. The after-load LA depends on the LV end-diastolic pressure and LV wall stiffness; the function of the LA reservoir period ensures that the LV can be lled quickly under short-term and low-load conditions [11,36].…”

Section: La and LV Dysfunction In Patients With T2dmmentioning

confidence: 99%

Left-atrioventricular interaction and left-atrial deformation in type 2 diabetes mellitus patients with or without chronic aortic regurgitation: A 3.0T cardiac magnetic resonance feature-tracking study

Shen,

Jiang,

Shi

et al. 2023

Preprint

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Background: The prevalence of type 2 diabetes mellitus (T2DM) and chronic aortic regurgitation (AR) increases with age and might increase cardiac morbidity and mortality; however, their comprehensive effects based on cardiac strain remain unexplored. This study aimed to use cardiac magnetic resonance feature tracking to investigate the additive effects of T2DM and AR on the left heart and left-atrioventricular (LA) interaction in patients with T2DM and AR. Methods: A total of 286 patients with T2DM (203 without AR, 83 with AR) and 105 normal controls were retrospectively included from January 2015 to October 2022. The patients with T2DM and AR were divided according to echocardiographic findings into three AR groups: mild (n = 39), moderate (n = 25), and severe (n = 19)]. The LA phasic function and left-ventricular (LV) function parameters were compared to determine the additive effects of T2DM and AR and their interaction. Multivariate analysis was performed to identify the independent indicators of LA longitudinal strain. Results: Compared with controls, the patients with T2DM without AR had a lower total LA emptying fraction (LAEF) and passive LAEF (all P < 0.05). The patients with T2DM and mild AR showed decreased LA reservoir strain (εs) and passive strain (εe) (P < 0.001), whereas those with moderate and severe AR showed significant increases in LA volume and LV volume but a decrease in LAEF, LA strain, and LV ejection fraction (all P < 0.05). In the patients with T2DM and AR, the εs was independently correlated with LV end-diastolic volume (LVEDV) (β = −0.304), regurgitation degree (β = −0.43), and LV mass index (LVMI) (β = −0.312). The active strain (εa) was independently correlated with regurgitation degree (β = −0.478) and LVMI (β = −0.364), whereas the εe was independently correlated with age (β = −0.226) and diabetes duration (β = −0.256, all P < 0.05). Conclusion: AR may aggravate LA and LV dysfunction in patients with T2DM. Regurgitation degree was an independent factor contributing to εs and εa. Both LVEDV and LVMI were independent determinants affecting εs, and LVMI was an independent determinant of εa in patients with T2DM and AR.

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“…Cardiac magnetic resonance (CMR) has become an important tool in myocardial injury evaluation and longitudinal follow-up cardiac examination because of its advantages of being radiation-free, multi-sequence, and multi-parameter and high repeatability [ 6 – 8 ]. CMR first-pass contrast-enhanced perfusion imaging has evolved into an established technique with a good clinical application over the past 2 decades [ 5 , 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Early left ventricular microvascular dysfunction in diabetic pigs: a longitudinal quantitative myocardial perfusion CMR study

Jiang,

Yan,

Zhang

et al. 2024

Cardiovasc Diabetol

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Background Microvascular pathology is one of the main characteristics of diabetic cardiomyopathy; however, the early longitudinal course of diabetic microvascular dysfunction remains uncertain. This study aimed to investigate the early dynamic changes in left ventricular (LV) microvascular function in diabetic pig model using the cardiac magnetic resonance (CMR)-derived quantitative perfusion technique. Methods Twelve pigs with streptozotocin-induced diabetes mellitus (DM) were included in this study, and longitudinal CMR scanning was performed before and 2, 6, 10, and 16 months after diabetic modeling. CMR-derived semiquantitative parameters (upslope, maximal signal intensity, perfusion index, and myocardial perfusion reserve index [MPRI]) and fully quantitative perfusion parameters (myocardial blood flow [MBF] and myocardial perfusion reserve [MPR]) were analyzed to evaluate longitudinal changes in LV myocardial microvascular function. Pearson correlation was used to analyze the relationship between LV structure and function and myocardial perfusion function. Results With the progression of DM duration, the upslope at rest showed a gradually increasing trend (P = 0.029); however, the upslope at stress and MBF did not change significantly (P > 0.05). Regarding perfusion reserve function, both MPRI and MPR showed a decreasing trend with the progression of disease duration (MPRI, P = 0.001; MPR, P = 0.042), with high consistency (r = 0.551, P < 0.001). Furthermore, LV MPR is moderately associated with LV longitudinal strain (r = − 0.353, P = 0.022), LV remodeling index (r = − 0.312, P = 0.033), fasting blood glucose (r = − 0.313, P = 0.043), and HbA1c (r = − 0.309, P = 0.046). Microscopically, pathological results showed that collagen volume fraction increased gradually, whereas no significant decrease in microvascular density was observed with the progression of DM duration. Conclusions Myocardial microvascular reserve function decreased gradually in the early stage of DM, which is related to both structural (but not reduced microvascular density) and functional abnormalities of microvessels, and is associated with increased blood glucose, reduced LV deformation, and myocardial remodeling.

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The worsening effect of anemia on left ventricular function and global strain in type 2 diabetes mellitus patients: a 3.0 T CMR feature tracking study

Cited by 7 publications

References 35 publications

Inter-relationships of risk factors and pathways associated with all-cause mortality in patients with chronic schizophrenia

Inter-relationships of risk factors and pathways associated with all-cause mortality in patients with chronic schizophrenia

Left-atrioventricular interaction and left-atrial deformation in type 2 diabetes mellitus patients with or without chronic aortic regurgitation: A 3.0T cardiac magnetic resonance feature-tracking study

Early left ventricular microvascular dysfunction in diabetic pigs: a longitudinal quantitative myocardial perfusion CMR study

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