Distinct non-ischemic myocardial late gadolinium enhancement lesions in patients with type 2 diabetes

Abstract

Background Cardiovascular magnetic resonance imaging (CMR) have described localised non-ischemic late gadolinium enhancement (LGE) lesions of prognostic importance in various non-ischemic cardiomyopathies. Ischemic LGE lesions are prevalent in diabetes (DM), but non-ischemic LGE lesions have not previously been described or systematically studied in DM. Methods 296 patients with type 2 DM (T2DM) and 25 sex-matched control subjects underwent echocardiography and CMR including adenosine-stress perfusion, T1-mapping and LGE. Results 264 patients and all control subjects completed the CMR protocol. 78.4% of patients with T2DM had no LGE lesions; 11.0% had ischemic LGE lesions only; 9.5% had non-ischemic LGE lesions only; and 1.1% had both one ischemic and one non-ischemic lesion. The non-ischemic LGE lesions were situated mid-myocardial in the basal lateral or the basal inferolateral part of the left ventricle and the affected segments showed normal to high wall thickness and normal contraction. Patients with non-ischemic LGE lesions in comparison with patients without LGE lesions had increased myocardial mass (150 ± 34 vs. 133 ± 33 g, P = 0.02), average E/e’(9.9 IQR8.7–12.6 vs. 8.8 IQR7.4–10.7, P = 0.04), left atrial maximal volume (102 IQR84.6–115.2 vs. 91 IQR75.2–100.0 mL, P = 0.049), NT-proBNP (8.9 IQR5.9–19.7 vs. 5.9 IQR5.9–10.1 µmol/L, P = 0.02) and high-sensitive troponin (15.6 IQR13.0–26.1 vs. 13.0 IQR13.0–14.6 ng/L, P = 0.007) and a higher prevalence of retinopathy (48 vs. 25%, P = 0.009) and autonomic neuropathy (52 vs. 30.5%, P = 0.005). Conclusion A specific LGE pattern with lesions in the basal lateral or the basal inferolateral part of the left ventricle was found in patients with type 2 diabetes. Trial registrationhttps://www.clinicaltrials.gov. Unique identifier: NCT02684331.

Prediction of prognosis in patients with left ventricular dysfunction using three-dimensional strain echocardiography and cardiac magnetic resonance imaging

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Conductance artery stiffness impairs atrio-ventriculo-arterial coupling before manifestation of arterial hypertension or left ventricular hypertrophic remodelling

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Myocardial edema during chemotherapy for gynecologic malignancies: A cardiac magnetic resonance T2 mapping study

“…The detailed parameters were as follows: TE = 1.23 ms, TR = 38.34 ms, flip angle = 60°, slice thickness = 8 mm, matrix = 208 × 208 pixels, and FOV = 250 × 300 mm 2 ( 20 , 21 ). For LGE imaging, intravenous gadolinium contrast (0.2 mL/kg) was first administered, a segmented phase-sensitive inversion recovery sequence with turbo FLASH readout at 17–19 minutes post contrast was then performed ( 22 , 23 ): TR = 1.44 ms, TE = 300 ms, flip angle = 40°, slice thickness = 4 mm, matrix = 84 × 176 pixels, FOV = 153 × 106 mm. T2 mapping images were obtained in the basal, middle, apical short-axis, and four-chamber planes; cine and LGE images were obtained in the two-chamber, three-chamber and four-chamber planes, and a continuous stack of short-axis planes with full left ventricular (LV) coverage.…”