Aggravation of functional mitral regurgitation on left ventricle stiffness in type 2 diabetes mellitus patients evaluated by CMR tissue tracking

Abstract

Background Functional mitral regurgitation (FMR) is one of the most common heart valve diseases in diabetes and may increase left ventricular (LV) preload and aggravate myocardial stiffness. This study aimed to investigate the aggravation of FMR on the deterioration of LV strain in type 2 diabetes mellitus (T2DM) patients and explore the independent indicators of LV peak strain (PS). Materials and methods In total, 157 T2DM patients (59 patients with and 98 without FMR) and 52 age- and sex-matched healthy control volunteers were included and underwent cardiac magnetic resonance examination. T2DM with FMR patients were divided into T2DM patients with mild (n = 21), moderate (n = 19) and severe (n = 19) regurgitation. LV function and global strain parameters were compared among groups. Multivariate analysis was used to identify the independent indicators of LV PS. Results The T2DM with FMR had lower LV strain parameters in radial, circumferential and longitudinal direction than both the normal and the T2DM without FMR (all P < 0.05). The mild had mainly decreased peak diastolic strain rate (PDSR) compared to the normal. The moderate had decreased peak systolic strain rate (PSSR) compared to the normal and PDSR compared to the mild and the normal. The severe FMR group had decreased PDSR and PSSR compared to the mild and the normal (all P < 0.05). Multiple linear regression showed that the regurgitation degree was independent associated with radial (β = − 0.272), circumferential (β = − 0.412) and longitudinal (β = − 0.347) PS; the months with diabetes was independently associated with radial (β = − 0.299) and longitudinal (β = − 0.347) PS in T2DM with FMR. Conclusion FMR may aggravate the deterioration of LV stiffness in T2DM patients, resulting in decline of LV strain and function. The regurgitation degree and months with diabetes were independently correlated with LV global PS in T2DM with FMR.

Effect of Mitral Regurgitation on Left Ventricular Deformation in Myocardial Infarction Patients: Evaluation by Cardiac Magnetic Resonance Imaging

“…S1 in the Supplemental Material). According to those MRF results, the MI (MR+) group was divided into three subgroups (mild, MRF <30%, 25 cases; moderate, 30% ≤ MRF < 50%, 34 cases; and severe, MRF ≥50%, 18 cases) 6,17 …”

“…Early diagnosis and evaluation of patients with MI and MR is extremely important. Cardiac magnetic resonance imaging can be used to evaluate the degree of LV function impairment in terms of LV morphology, diastolic and systolic function, and stress dynamics of the myocardium 4–6 . In tandem, LV strains have recently been used to predict adverse cardiovascular clinical events after MI 7,8 .…”

“…Cardiac magnetic resonance imaging can be used to evaluate the degree of LV function impairment in terms of LV morphology, diastolic and systolic function, and stress dynamics of the myocardium. [4][5][6] In tandem, LV strains have recently been used to predict adverse cardiovascular clinical events after MI. 7,8 Assessing the changes in cardiac volume, function, and biomechanics prior to a cardiovascular event is important for reducing the cardiovascular risk in such patients and improving the healing process.…”

The adverse impact of coronary artery disease on left ventricle systolic and diastolic function in patients with type 2 diabetes mellitus: a 3.0T CMR study

“…Cardiac magnetic resonance (CMR) tissue tracking is a novel method of measuring LV strain and strain rates, which has been applied to evaluate the LV systolic or diastolic function in diverse populations and shown high sensitivity and reproducibility [ 8 – 10 ]. To the best of our knowledge, several previous studies have focused on the additive effect of hypertension or valvular regurgitation on the LV function in T2DM patients [ 11 , 12 ], the role of CAD on which has rarely been explored in those patients. [ 13 ] Accordingly, this study aimed to investigate how CAD affect LV systolic and diastolic function in T2DM patients and further to explore the independent determinants of decreased LV function.…”

Additive Effects of Obesity on Myocardial Microcirculation and Left Ventricular Deformation in Essential Hypertension: A Contrast-Enhanced Cardiac Magnetic Resonance Imaging Study

“…In addition, conventional functional parameters are not sensitive enough to detect minor abnormalities of LV function, such as left ventricular ejection fraction (LVEF), which may mask the impairment in the preclinical stage ( 15 ). CMR feature tracking (CMR-FT) can drive LV deformation indicators using only clinical routine cine images, and has been well established as a sensitive technique for evaluating subclinical LV dysfunction ( 16 , 17 ).…”