Shang Yongning, Zhang Xiaochun, Leng Weiling, Lei Xiaotian, Chen Liu, Liang Ziwen, Wang Jian
Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, China.
Int J Cardiovasc Imaging. 2018 Jan;34(1):141-151. doi: 10.1007/s10554-017-1213-0. Epub 2017 Jul 18.
The aims of this study were to use cardiovascular magnetic resonance (CMR) cine to assess left atrium (LA) and left ventricle (LV) function and structure in normotensive type 2 diabetes mellitus (T2DM) patients and to identify the most sensitive index of those T2DM-related cardiac changes. Fifty T2DM patients with normotension (25 males, age 54.7 ± 8.7 years, duration of diabetes: 7.5 ± 5.1 years) and 35 controls (16 males, age: 52.2 ± 13.2 years) were prospectively enrolled. All patients were scanned using CMR four- and two-chamber long-axis cine to assess LA and LV structure and function. Normotensive T2DM patients were associated with decreased LA total ejection fraction (EF), passive EF and LV end diastolic volume, normal LA active EF and LV myocardial mass and increased LV mass/volume (M/V). LA total EF and passive EF correlated with body mass index, duration of diabetes and M/V. To differentiate between diabetic patients and healthy controls, area under the receiver operating characteristic (ROC) curve (AUC) values were calculated to be 0.763, 0.706, 0.647 and 0.649 for LA passive EF, total EF, LVEDV and M/V, respectively. The addition of LA total EF, LVEDV, M/V and the combination thereof did not significantly improve AUC values in a model containing LA passive EF. Normotensive T2DM patients were associated with LA decreased total ejection fraction, decreased passive EF and LV concentric remodeling. Among these indices, LA passive EF was the most sensitive to T2DM-related LA function changes.
本研究的目的是使用心血管磁共振（CMR）电影成像来评估血压正常的2型糖尿病（T2DM）患者的左心房（LA）和左心室（LV）功能及结构，并确定那些与T2DM相关的心脏变化中最敏感的指标。前瞻性纳入了50例血压正常的T2DM患者（25例男性，年龄54.7±8.7岁，糖尿病病程：7.5±5.1年）和35例对照者（16例男性，年龄：52.2±13.2岁）。所有患者均使用CMR四腔和两腔长轴电影成像进行扫描，以评估LA和LV的结构及功能。血压正常的T2DM患者与LA总射血分数（EF）、被动EF降低及LV舒张末期容积减小有关，LA主动EF和LV心肌质量正常，LV质量/容积（M/V）增加。LA总EF和被动EF与体重指数、糖尿病病程及M/V相关。为区分糖尿病患者和健康对照者，计算了受试者操作特征（ROC）曲线下面积（AUC）值，LA被动EF、总EF、LVEDV和M/V的AUC值分别为0.763、0.706、0.647和0.649。在包含LA被动EF的模型中，添加LA总EF、LVEDV、M/V及其组合并未显著提高AUC值。血压正常的T2DM患者与LA总射血分数降低、被动EF降低及LV向心性重塑有关。在这些指标中，LA被动EF对与T2DM相关的LA功能变化最敏感。
