心脏磁共振 T1 mapping 评估 2 型糖尿病患者心肌纤维化：与左心室长轴舒张功能障碍的相关性。

Cardiac magnetic resonance T1 mapping for evaluating myocardial fibrosis in patients with type 2 diabetes mellitus: correlation with left ventricular longitudinal diastolic dysfunction.

机构信息

Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, No.52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China.

出版信息

Eur Radiol. 2022 Nov;32(11):7647-7656. doi: 10.1007/s00330-022-08800-9. Epub 2022 May 14.

DOI:10.1007/s00330-022-08800-9

PMID:35567605

Abstract

OBJECTIVES

We aimed to evaluate myocardial fibrosis using cardiac magnetic resonance (CMR) T1 mapping in type 2 diabetes mellitus (T2DM) patients and investigate the association between left ventricular (LV) subclinical myocardial dysfunction and myocardial fibrosis.

METHODS

The study included 37 short-term (≤ 5 years) and 44 longer-term (> 5 years) T2DM patients and 41 healthy controls. The LV global strain parameters and T1 mapping parameters were compared between the abovementioned three groups. The association of T1 mapping parameters with diabetes duration, in addition to other risk factors, was determined using multivariate linear regression analysis. The correlation between LV strain parameters and T1 mapping parameters was evaluated using Pearson's correlation.

RESULTS

The peak diastolic strain rates (PDSRs) were significantly lower in longer-term T2DM patients compared to those in healthy subjects and short-term T2DM patients (p < 0.05). The longitudinal peak systolic strain rate and peak strain were significantly lower in the longer-term T2DM compared with the short-term T2DM group (p < 0.05). The extracellular volumes (ECVs) were higher in both subgroups of T2DM patients compared with control subjects (all p < 0.05). Multivariate linear regression analysis showed that diabetes duration was independently associated with ECV (β = 0.413, p < 0.001) by taking covariates into account. Pearson's analysis showed that ECV was associated with longitudinal PDSR (r = - 0.441, p < 0.001).

CONCLUSION

T1 mapping could detect abnormal myocardial fibrosis early in patients with T2DM, which can cause a decline in the LV diastolic function.

KEY POINTS

• CMR T1 mapping could detect abnormal myocardial fibrosis early in patients with T2DM. • The diabetes duration was independently associated with ECV. • Myocardial fibrosis can cause a decline in the LV diastolic function in T2DM patients.

摘要

目的

我们旨在通过心脏磁共振（CMR）T1 映射评估 2 型糖尿病（T2DM）患者的心肌纤维化，并研究左心室（LV）亚临床心肌功能障碍与心肌纤维化之间的关系。

方法

本研究纳入了 37 例短期（≤5 年）和 44 例长期（>5 年）T2DM 患者以及 41 名健康对照者。比较了上述三组患者的 LV 整体应变参数和 T1 映射参数。采用多元线性回归分析确定 T1 映射参数与糖尿病病程以及其他危险因素的关系。采用 Pearson 相关分析评估 LV 应变参数与 T1 映射参数之间的相关性。

结果

与健康对照组和短期 T2DM 患者相比，长期 T2DM 患者的峰值舒张应变率（PDSR）明显降低（p<0.05）。与短期 T2DM 组相比，长期 T2DM 组的纵向收缩期峰值应变率和峰值应变明显降低（p<0.05）。两组 T2DM 患者的细胞外容积（ECV）均高于对照组（均 p<0.05）。考虑到协变量，多元线性回归分析显示糖尿病病程与 ECV 独立相关（β=0.413，p<0.001）。Pearson 分析显示 ECV 与纵向 PDSR 相关（r=-0.441，p<0.001）。