Khan Jamal Nasir, Wilmot Emma Gwyn, Leggate Melanie, Singh Anvesha, Yates Thomas, Nimmo Myra, Khunti Kamlesh, Horsfield Mark A, Biglands John, Clarysse Patrick, Croisille Pierre, Davies Melanie, McCann Gerry Patrick
Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK.
Eur Heart J Cardiovasc Imaging. 2014 Nov;15(11):1263-9. doi: 10.1093/ehjci/jeu121. Epub 2014 Jun 26.
To assess the cardiac, vascular, anthropometric, and biochemical determinants of subclinical diastolic dysfunction in younger adults with Type 2 diabetes mellitus (T2DM) using multiparametric contrast-enhanced cardiovascular magnetic resonance (CMR) imaging.
Twenty adults <40 years with T2DM [mean age 31.8(6.6) years, T2DM duration 4.7(4.0) years] and 20 age and sex-matched controls [10 obese non-diabetic controls and 10 lean controls (LC)] were studied. Cardiac volumes and function, circumferential strain and peak early diastolic strain rate (PEDSR), myocardial perfusion reserve, aortic stiffness (distensibility, pulse-wave velocity), focal fibrosis on late gadolinium enhancement, and pre- and post-contrast T1 mapping for contrast agent partition coefficient (subset, n = 26) were determined by CMR. In the T2DM cohort, mean aortic distensibility correlated with PEDSR (r = 0.564, P = 0.023) and diabetes duration correlated inversely with PEDSR (r = -0.534, P = 0.015) on univariate analysis. There was a close association between PEDSR and peak systolic strain (r = -0.580, P = 0.007).
In young adults with T2DM, diabetes duration and aortic distensibility were associated with diastolic dysfunction. Interventional studies are required to assess whether cardiac dysfunction can be reversed in this phenotype of patients.
使用多参数对比增强心血管磁共振（CMR）成像评估2型糖尿病（T2DM）年轻成人亚临床舒张功能障碍的心脏、血管、人体测量学和生化决定因素。
研究了20名年龄小于40岁的T2DM成人[平均年龄31.8（6.6）岁，T2DM病程4.7（4.0）年]以及20名年龄和性别匹配的对照者[10名肥胖非糖尿病对照者和10名瘦对照者（LC）]。通过CMR测定心脏容积和功能、圆周应变和舒张早期峰值应变率（PEDSR）、心肌灌注储备、主动脉僵硬度（扩张性、脉搏波速度）、钆增强晚期的局灶性纤维化以及用于造影剂分配系数的对比剂前后T1映射（子集，n = 26）。在T2DM队列中，单因素分析显示平均主动脉扩张性与PEDSR相关（r = 0.564，P = 0.023），糖尿病病程与PEDSR呈负相关（r = -0.534，P = 0.015）。PEDSR与收缩期峰值应变之间存在密切关联（r = -0.580，P = 0.007）。
在患有T2DM的年轻成人中，糖尿病病程和主动脉扩张性与舒张功能障碍相关。需要进行干预性研究以评估在此类患者表型中的心功能障碍是否可以逆转。
