Shen Meng-Ting, Yang Zhi-Gang, Guo Ying-Kun, Shi Ke, Jiang Li, Wang Jin, Yan Wei-Feng, Qian Wen-Lei, Shen Li-Ting, Li Yuan
Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
J Magn Reson Imaging. 2025 Feb;61(2):911-925. doi: 10.1002/jmri.29469. Epub 2024 Jun 10.
The impact of functional mitral regurgitation and type 2 mellitus diabetes (T2DM) on left ventricular (LV) strain in nonischemic dilated cardiomyopathy (NIDCM) patients remains unclear.
To evaluate the impact of mitral regurgitation severity on LV strain, and explore additive effect of T2DM on LV function across varying mitral regurgitation severity levels in NIDCM patients.
Retrospective.
352 NIDCM (T2DM-) patients (49.1 ± 14.6 years, 67% male) (207, 85, and 60 no/mild, moderate, and severe mitral regurgitation) and 96 NIDCM (T2DM+) patients (55.2 ± 12.4 years, 77% male) (47, 30, and 19 no/mild, moderate, and severe mitral regurgitation).
FIELD STRENGTH/SEQUENCE: 3.0 T/balanced steady-state free precession sequence.
LV geometric parameters and strain were measured and compared among groups. Determinants of LV strain were investigated.
Student's t-test, Mann-Whitney U test, one-way ANOVA, Kruskal-Wallis test, univariable and multivariable linear regression. P < 0.05 was considered statistically significant.
LV GLPS and longitudinal PDSR decreased gradually with increasing mitral regurgitation severity in NIDCM patients with T2DM(GLPS: -5.7% ± 2.1% vs. -4.3% ± 1.6% vs. -2.6% ± 1.3%; longitudinal PDSR:0.5 ± 0.2 sec vs. 0.4 ± 0.2 sec vs. 0.3 ± 0.1 sec). NIDCM (T2DM+) demonstrated decreased GCPS and GLPS in the no/mild subgroup, reduced LV GCPS, GLPS, and longitudinal PDSR in the moderate subgroup, and reduced GRPS, GCPS, GLPS, and longitudinal PDSR in the severe subgroup compared with NIDCM (T2DM-) patients. Multivariable regression analysis identified that mitral regurgitation severity (β = -0.13, 0.15, and 0.25 for GRPS, GCPS, and GLPS) and the presence of T2DM (β = 0.14 and 0.13 for GCPS and GLPS) were independent determinants of LV strains in NIDCM patients.
Increased mitral regurgitation severity is associated with reduced LV strains in NIDCM patients with T2DM. The presence of T2DM exacerbated the decline of LV function across various mitral regurgitation levels in NIDCM patients, resulting in reduced LV strains.
Stage 3.
功能性二尖瓣反流和2型糖尿病（T2DM）对非缺血性扩张型心肌病（NIDCM）患者左心室（LV）应变的影响尚不清楚。
评估二尖瓣反流严重程度对LV应变的影响，并探讨T2DM在不同二尖瓣反流严重程度水平下对NIDCM患者LV功能的附加作用。
回顾性研究。
352例非糖尿病NIDCM患者（49.1±14.6岁，67%为男性）（207例、85例和60例无/轻度、中度和重度二尖瓣反流）以及96例糖尿病NIDCM患者（55.2±12.4岁，77%为男性）（47例、30例和19例无/轻度、中度和重度二尖瓣反流）。
场强/序列：3.0T/平衡稳态自由进动序列。
测量并比较各组的LV几何参数和应变。研究LV应变的决定因素。
学生t检验、曼-惠特尼U检验、单因素方差分析、克鲁斯卡尔-沃利斯检验、单变量和多变量线性回归。P<0.05被认为具有统计学意义。
在糖尿病NIDCM患者中，LV全局纵向应变（GLPS）和纵向峰值舒张应变率（PDSR）随二尖瓣反流严重程度增加而逐渐降低（GLPS：-5.7%±2.1% vs. -4.3%±1.6% vs. -2.6%±1.3%；纵向PDSR：0.5±0.2秒 vs. 0.4±0.2秒 vs. 0.3±0.1秒）。与非糖尿病NIDCM患者相比，糖尿病NIDCM患者在无/轻度亚组中表现出全局圆周应变（GCPS）和GLPS降低，在中度亚组中LV的GCPS、GLPS和纵向PDSR降低，在重度亚组中GRPS、GCPS、GLPS和纵向PDSR降低。多变量回归分析确定二尖瓣反流严重程度（GRPS、GCPS和GLPS的β值分别为-0.13、0.15和0.25）和T2DM的存在（GCPS和GLPS的β值分别为0.14和0.13）是NIDCM患者LV应变的独立决定因素。
二尖瓣反流严重程度增加与糖尿病NIDCM患者LV应变降低相关。T2DM的存在加剧了NIDCM患者在不同二尖瓣反流水平下LV功能的下降，导致LV应变降低。
3级。
