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应用心血管磁共振特征追踪技术评价糖尿病前期及糖尿病患者的左心室收缩及舒张功能。

Evaluation of left ventricular systolic and diastolic function in subjects with prediabetes and diabetes using cardiovascular magnetic resonance-feature tracking.

机构信息

Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.

Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Acta Diabetol. 2022 Apr;59(4):491-499. doi: 10.1007/s00592-021-01822-7. Epub 2021 Nov 15.

Abstract

AIMS

The aim of this study was to evaluate alterations in left ventricular (LV) systolic and diastolic function in subjects with prediabetes and diabetes using cardiovascular magnetic resonance-feature tracking (CMR- FT).

METHODS

We included 35 subjects with prediabetes, 30 subjects with diabetes, and 33 healthy controls of similar age and sex distributions who underwent CMR examination. LV global radial, circumferential, and longitudinal strain (GRS, GCS, and GLS), peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR) were measured and compared among the three groups. Pearson's correlation and linear regression analyses were applied for statistical analyses.

RESULTS

Subjects with prediabetes and diabetes had a significantly lower GLS than healthy controls, but there were no significant differences in ejection fraction (EF), GRS, GCS, or global radial, circumferential and longitudinal PSSR among the three groups. Global radial, circumferential, and longitudinal PDSR in patients with diabetes were all significantly lower than those in the healthy controls. Compared to subjects with prediabetes, patients with diabetes had a significantly lower global circumferential PDSR. Global longitudinal PDSR in subjects with prediabetes was significantly lower than that in healthy controls. Multivariable linear regression analyses demonstrated that elevated HbA1c levels were independently associated with decreased global circumferential and longitudinal PDSR (β = -0.203, p = 0.023; β = -0.207, p = 0.040, respectively).

CONCLUSIONS

CMR-FT has potential value to evaluate early alterations in LV systolic and diastolic function in subjects with prediabetes and diabetes. Elevated HbA1c levels were independently associated with impaired LV diastolic function in the general population free of overt cardiovascular diseases.

摘要

目的

本研究旨在使用心血管磁共振(CMR)-特征追踪(FT)评估糖尿病前期和糖尿病患者左心室(LV)收缩和舒张功能的变化。

方法

我们纳入了 35 名糖尿病前期患者、30 名糖尿病患者和 33 名年龄和性别分布相似的健康对照者,所有患者均接受了 CMR 检查。比较三组之间的 LV 整体径向、周向和纵向应变(GRS、GCS 和 GLS)、收缩期峰值应变率(PSSR)和舒张期峰值应变率(PDSR)。应用 Pearson 相关和线性回归分析进行统计分析。

结果

糖尿病前期和糖尿病患者的 GLS 明显低于健康对照组,但三组间射血分数(EF)、GRS、GCS 或整体径向、周向和纵向 PSSR 均无显著差异。糖尿病患者的整体径向、周向和纵向 PDSR 均明显低于健康对照组。与糖尿病前期患者相比,糖尿病患者的整体周向 PDSR 明显降低。糖尿病前期患者的整体纵向 PDSR 明显低于健康对照组。多变量线性回归分析表明,HbA1c 水平升高与整体周向和纵向 PDSR 降低独立相关(β=-0.203,p=0.023;β=-0.207,p=0.040)。

结论

CMR-FT 具有评估糖尿病前期和糖尿病患者 LV 收缩和舒张功能早期变化的潜力。在无明显心血管疾病的普通人群中,HbA1c 水平升高与 LV 舒张功能受损独立相关。

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