Zhu Tong, Zeng Wen, Chen Yushu, Zhang Yu, Sun Jiayu, Liang Zhigang, Yang Zunyuan, Cheng Wei, Wang Lei, Song Bin, Wu Bing, Wang Fangtong, Liang Yinan, Gong Li, Zheng Jie, Gao Fabao
Department of Radiology, West China Hospital, Sichuan University, 37 Guoxue alley, Chengdu, 610041, Sichuan Province, China.
Sichuan Primed Shines Bio-tech Co., Ltd, Chengdu, China.
BMC Med Imaging. 2018 Nov 26;18(1):47. doi: 10.1186/s12880-018-0288-y.
Spontaneous T2DM in rhesus monkeys manifests as isolated diastolic dysfunction in the early stage of diabetic cardiomyopathy, similar to humans. Myocardial deformation measurements have emerged as a superior way to measure left ventricular (LV) function in the early stage of cardiac dysfunction, making it possible to further evaluate early-stage LV dysfunction in spontaneous T2DM rhesus monkeys.
Spontaneous T2DM rhesus monkeys with isolated diastolic dysfunction (T2DM-DD, n = 10) and corresponding nondiabetic healthy animals (ND, n = 9) were prospectively scanned for a CMR study. Circumferential and longitudinal peak systolic strain (Ecc, Ell), time to peak strain (tEcc, tEll) and peak diastolic strain rate (CSR, LSR) obtained from 2D/3D CMR-TT were compared with those obtained from CMR tagging separately. In addition, all CMR imaging protocols were performed twice in 9 ND animals to assess test-retest reproducibility.
Compared with the ND group, the T2DM-DD monkeys demonstrated significantly impaired LV Ecc (- 10.63 ± 3.23 vs - 14.18 ± 3.19, p < 0.05), CSR (65.50 ± 14.48 vs 65.50 ± 14.48, p < 0.01), Ell (- 9.11 ± 2.59 vs - 14.17 ± 1.68, p < 0.05), and LSR (59.43 ± 19.17 vs 108.46 ± 22.33, p < 0.01) with the tagging. Only Ecc (- 13.10 ± 2.47 vs - 19.03 ± 3.69, p < 0.01) and CSR (148.90 ± 31.27 vs 202.00 ± 51.88, p < 0.01) were significantly reduced with 2D CMR-TT, and only Ecc (- 13.77 ± 1.98 vs - 17.26 ± 3.78, p < 0.05) was significantly reduced with 3D CMR-TT. Moreover, 2D/3D CMR-TT-derived Ecc and CSR correlated with the corresponding tagging values collectively, with a statistically significant ICC value (p < 0.05). Test-retest repeatability analysis showed that most tagging-derived biomarkers had acceptable repeatability (p < 0.01). In addition, 2D CMR-TT-derived indicators were poorer than those derived from the tagging method but better than those obtained using the 3D method, with larger ICCs except for tEcc (p < 0.05).
LV systolic and diastolic deformations were impaired in spontaneous T2DM rhesus monkeys previously diagnosed with isolated diastolic dysfunction by echocardiography. The 2D CMR-TT-derived Ecc and CSR were effective in the evaluation of the myocardial systolic and diastolic functions of early-diabetic cardiomyopathy, with relatively higher test-retest reproducibility and acceptable correlation with the tagging method compared with the 3D CMR-TT method.
恒河猴自发性2型糖尿病在糖尿病性心肌病早期表现为单纯舒张功能障碍，与人类相似。心肌变形测量已成为在心脏功能障碍早期测量左心室（LV）功能的一种优越方法，使得进一步评估自发性2型糖尿病恒河猴的早期左心室功能障碍成为可能。
对患有单纯舒张功能障碍的自发性2型糖尿病恒河猴（T2DM-DD，n = 10）和相应的非糖尿病健康动物（ND，n = 9）进行前瞻性扫描以进行心脏磁共振成像（CMR）研究。将二维/三维CMR-TT获得的圆周和纵向峰值收缩期应变（Ecc、Ell）、达到峰值应变的时间（tEcc、tEll）和舒张期峰值应变率（CSR、LSR）与分别从CMR标记获得的结果进行比较。此外，对9只ND动物的所有CMR成像方案进行了两次，以评估重测再现性。
与ND组相比，T2DM-DD猴的左心室Ecc（-10.63±3.23对-14.18±3.19，p<0.05）、CSR（65.50±14.48对65.50±14.48，p<0.01）、Ell（-9.11±2.59对-14.17±1.68，p<0.05）和LSR（59.43±19.17对108.46±22.33，p<0.01）通过标记法测量明显受损。二维CMR-TT仅使Ecc（-13.10±2.47对-19.03±3.69，p<0.01）和CSR（148.90±31.27对202.00±51.88，p<0.01）显著降低，三维CMR-TT仅使Ecc（-13.77±1.98对-17.26±3.78，p<0.05）显著降低。此外，二维/三维CMR-TT得出的Ecc和CSR与相应的标记值总体相关，组内相关系数（ICC）值具有统计学意义（p<0.05）。重测重复性分析表明，大多数标记衍生的生物标志物具有可接受的重复性（p<0.01）。此外，二维CMR-TT得出的指标比标记法得出的指标差，但比三维方法得出的指标好，除tEcc外ICC值更大（p<0.05）。
先前经超声心动图诊断为单纯舒张功能障碍的自发性2型糖尿病恒河猴的左心室收缩和舒张变形受损。二维CMR-TT得出的Ecc和CSR在评估早期糖尿病性心肌病的心肌收缩和舒张功能方面有效，与三维CMR-TT方法相比，具有相对较高的重测再现性和与标记法可接受的相关性。
