Chen Lei, Qiu Bowen, Du Xinjia, Liu Jiahua, Lu Yuan, Che Wenliang, Chen Wensu
Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2025 Jun 25;16:1534236. doi: 10.3389/fendo.2025.1534236. eCollection 2025.
Extracellular volume (ECV) is an important marker of myocardial fibrosis. However, the prognostic role of ECV in diabetes patients is unknown. In addition, synthetic ECV without blood sampling has not been reported in diabetes cohorts. This study investigated the establishment and validation of synthetic ECV and its prognostic value in type 2 diabetes mellitus (T2DM) patients with acute myocardial infarction (AMI).
This single-center retrospective study included T2DM patients with AMI who completed cardiac magnetic resonance (CMR) during hospitalization. The patients were randomly divided into a derivation group and a validation group. MACE included all-cause death, recurrent MI, stroke, or heart failure. ECV in integral (Integral ECV), non-myocardial infarction region (NMI-ECV), and myocardial infarction region (MI-ECV) was obtained by CMR.
The study included 157 patients, with a median time from admission to CMR of 4 days. Bland-Altman and Pearson analysis showed good consistency and correlation between conventional ECV and synthetic ECV. Cox regression showed that Integral ECV (HR=1.07; 95%CI: 1.01 ~ 1.13, p = 0.023), MI-ECV (HR=1.03; 95%CI: 1.00 ~ 1.07, p = 0.024), and NMI-ECV (HR=1.07; 95%CI: 1.00 ~ 1.14, p = 0.039) were independently associated with MACE in different models. Kaplan-Meier analysis indicated that patients with a high synthetic ECV had a significantly higher MACE risk.
Synthetic ECV is strongly consistent and correlated with conventional ECV in T2DM patients with AMI. Elevated synthetic ECV is an independent risk factor for MACE in T2DM patients with AMI.
细胞外容积（ECV）是心肌纤维化的重要标志物。然而，ECV在糖尿病患者中的预后作用尚不清楚。此外，在糖尿病队列中尚未有关于无需采血的合成ECV的报道。本研究调查了合成ECV在2型糖尿病（T2DM）合并急性心肌梗死（AMI）患者中的建立、验证及其预后价值。
本单中心回顾性研究纳入了住院期间完成心脏磁共振成像（CMR）的T2DM合并AMI患者。患者被随机分为推导组和验证组。主要不良心血管事件（MACE）包括全因死亡、复发性心肌梗死、中风或心力衰竭。通过CMR获得整体ECV（Integral ECV）、非心肌梗死区域（NMI-ECV）和心肌梗死区域（MI-ECV）的ECV。
该研究纳入了157例患者，从入院到CMR的中位时间为4天。Bland-Altman分析和Pearson分析显示传统ECV与合成ECV之间具有良好的一致性和相关性。Cox回归分析表明，在不同模型中，整体ECV（HR=1.07；95%CI：1.011.13，p=0.023）、MI-ECV（HR=1.03；95%CI：1.001.07，p=0.024）和NMI-ECV（HR=1.07；95%CI：1.00~1.14，p=0.039）与MACE独立相关。Kaplan-Meier分析表明，合成ECV高的患者发生MACE的风险显著更高。
在T2DM合并AMI患者中，合成ECV与传统ECV高度一致且相关。合成ECV升高是T2DM合并AMI患者发生MACE的独立危险因素。
