Cardiovascular Magnetic Resonance in Diabetic Patients

Nagel, Eike

doi:10.1161/circimaging.116.004699

Cited by 2 publications

(3 citation statements)

References 24 publications

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“…Patients with diabetes experience an increased risk of cardiovascular morbidity and mortality due to several pathophysiological conditions, such as epicardial CAD, CMD, cardiac remodelling with heart failure, and peripheral vascular diseases [92]. Stress CMR has made continuous progress in assessing patients with diabetes to understand the natural history and prognosis, especially in detecting silent epicardial CAD.…”

Section: Diabetesmentioning

confidence: 99%

Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

et al. 2023

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Stress cardiovascular magnetic resonance (CMR) imaging is a well-validated non-invasive stress test to diagnose significant coronary artery disease (CAD), with higher diagnostic accuracy than other common functional imaging modalities. One-stop assessment of myocardial ischemia, cardiac function, and myocardial viability qualitatively and quantitatively has been proven to be a cost-effective method in clinical practice for CAD evaluation. Beyond diagnosis, stress CMR also provides prognostic information and guides coronary revascularisation. In addition to CAD, there is a large body of literature demonstrating CMR’s diagnostic performance and prognostic value in other common cardiovascular diseases (CVDs), especially coronary microvascular dysfunction (CMD). This review focuses on the clinical applications of stress CMR, including stress CMR scanning methods, practical interpretation of stress CMR images, and clinical utility of stress CMR in a setting of CVDs with possible myocardial ischemia.

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Section: Diabetesmentioning

confidence: 99%

Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

et al. 2023

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“…Despite these limitations, a systematic analysis of SPECT studies showed that in DM patients with and without symptoms, a normal SPECT indicates an annual event rate for MI/cardiac death around 1.9% (24). Finally, SPECT uses radioactive tracers that are not indicated in the young DM patients with rapid disease progression and atypical presentations, who need repeated reevaluation scans (4).…”

Section: Non-invasive Cardiovascular Imaging In Dmmentioning

confidence: 99%

“…Cardiovascular Magnetic Resonance is a non-radiative modality, with high spatial resolution (0.3-1mm) capable to provide details regarding both function and tissue characteristics in the same study (27). CMR is superior to all other modalities in detecting MI (4). The ICELAND MI study revealed an incidence of 27% MI in the general population between 67 and 93 years and 32% in patients with DM (27).…”

Section: Which Is the Place Of Cmr In Dm Evaluation?mentioning

confidence: 99%

Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus

et al. 2021

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Diabetes mellitus can independently contribute to cardiovascular disease and represents a severe risk factor for premature development of cardiovascular disease. A three-fold higher mortality than the general population has been observed in type 1 diabetes mellitus whereas a two- to four-fold increased probability to develop cardiovascular disease has been observed in type 2 diabetes mellitus. Cardiovascular magnetic resonance, a non-radiative modality, is superior to all other modalities in detecting myocardial infarction. The main cardiovascular magnetic resonance sequences used include a) balanced steady-state free precession (bSSFP) for function evaluation; b) T2-W for oedema detection; c) T1 W for ischemia detection during adenosine stress; and d) late gadolinium enhanced T1-W images (LGE), evaluated 15 min after injection of paramagnetic contrast agent gadolinium, which permit the diagnosis of replacement fibrosis, which appears white in the middle of suppressed, nulled myocardium. Although LGE is the technique of choice for diagnosis of replacement fibrosis, it cannot assess diffuse myocardial fibrosis. The application of T1 mapping (native or pre contrast and post contrast) allows identification of diffuse myocardial fibrosis, which is not detectable my other means. Native T1 and Contrast-enhanced T1 mapping are involved in the extracellular volume fraction (ECV) calculation. Recently, 1H-cardiovascular magnetic resonance spectroscopy has been applied to calculate the amount of myocardial triglycerides, but at the moment it is not part of the routine assessment of diabetes mellitus. The multifaceted nature of cardiovascular magnetic resonance has the great potential of concurrent evaluation of function and myocardial ischemia/fibrosis in the same examination and represents an indispensable tool for accurate diagnosis of cardiovascular disease in diabetes mellitus.

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Cardiovascular Magnetic Resonance in Diabetic Patients

Cited by 2 publications

References 24 publications

Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus

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