Myocardial native-T1 times are elevated as a function of hypertrophy, HbA1c, and heart rate in diabetic adults without diffuse fibrosis

Lam, Bess Yin-Hung; Stromp, Tori A; Hui, Zhengxiong; Vandsburger, Moriel

doi:10.1016/j.mri.2019.05.029

Cited by 11 publications

(11 citation statements)

References 38 publications

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“…The biological factor that determines an increase in native T1 is whether there is an increase in the interstitial space (e.g., fibrosis of cardiomyopathy) [ 15 ]. This study detected such an increase in native T1 among T2DM patients with preserved EF, which corroborates two previous studies [ 8 , 13 ]. In the subgroup analysis, although there was no significant difference in native T1 between normotensive T2DM patients and controls, myocardial ECV in these patients was higher than in the control group.…”

Section: Discussionsupporting

confidence: 93%

“…Using the CVI42 software, the myocardium of the LV (inner and outer contour) was segmented into the basal, mid, and apical ventricular slices of the short-axis images in accordance with recommendations that omitted the influence of the surrounding fat or blood. Segments affected by apparent artifacts or the presence of LGE were omitted to avoid distorting the measured values [ 6 , 13 ]. The LV myocardium was divided into 17 segments according to the American Heart Association classification.…”

Section: Methodsmentioning

confidence: 99%

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Hemoglobin A1c in type 2 diabetes mellitus patients with preserved ejection fraction is an independent predictor of left ventricular myocardial deformation and tissue abnormalities

Han

et al. 2023

BMC Cardiovasc Disord

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Background Early detection of subclinical myocardial dysfunction in patients with type 2 diabetes mellitus (T2DM) is essential for preventing heart failure. This study aims to search for predictors of left ventricular (LV) myocardial deformation and tissue abnormalities in T2DM patients with preserved ejection fraction by using CMR T1 mapping and feature tracking. Methods 70 patients and 44 sex- and age-matched controls (Cs) were recruited and underwent CMR examination to obtain LV myocardial extracellular volume fraction (ECV) and global longitudinal strain (GLS). The patients were subdivided into three groups, including 19 normotensive T2DM patients (G1), 19 hypertensive T2DM patients (G2) and 32 hypertensive patients (HT). The baseline biochemical indices were collected before CMR examination. Results LV ECV in T2DM patients was significantly higher than that in Cs (30.75 ± 3.65% vs. 26.33 ± 2.81%; p < 0.05). LV GLS in T2DM patients reduced compared with that in Cs (−16.51 ± 2.53% vs. −19.66 ± 3.21%, p < 0.001). In the subgroup analysis, ECV in G2 increased compared with that in G1 (31.92 ± 3.05% vs. 29.59 ± 3.90%, p = 0.032) and that in HT, too (31.92 ± 3.05% vs. 29.22 ± 6.58%, p = 0.042). GLS in G2 significantly reduced compared with that in G1 (−15.75 ± 2.29% vs. −17.27 ± 2.57%, p < 0.05) and in HT, too (−15.75 ± 2.29% vs. −17.54 ± 3.097%, p < 0.05). In T2DM group, including both G1 and G2, hemoglobin A1c (HbA1c) can independently forecast the increase in ECV (β = 0.274, p = 0.001) and decrease in GLS (β = 0.383, p = 0.018). Conclusions T2DM patients with preserved ejection fraction show increased ECV but deteriorated GLS, which may be exacerbated by hypertension of these patients. Hemoglobin A1c is an index that can independently predict T2DM patients’ LV myocardial deformation and tissue abnormalities.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Hemoglobin A1c in type 2 diabetes mellitus patients with preserved ejection fraction is an independent predictor of left ventricular myocardial deformation and tissue abnormalities

Han

et al. 2023

BMC Cardiovasc Disord

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“…It was also associated with late gadolinium enhancement (LGE) lesions that could not be explained by previous infarcts (non-ischemic LGE lesions) and prevalent complications of diabetes (retinopathy, autonomic neuropathy) (93; Figures 4, 5). On the contrary, dissimilar results with regards to the association of diabetes with increased ECV have been suggested by other groups (20,60,88,91,94,95). A recently published meta-analysis concluded that diabetes was associated with increased ECV but not with native T 1 increase and increased ECV was also associated with poor glycaemic control (64).…”

Section: Extracellular Volumementioning

confidence: 98%

Quantitative MRI in cardiometabolic disease: From conventional cardiac and liver tissue mapping techniques to multi-parametric approaches

Fotaki

Velasco²,

Prieto³

et al. 2023

Front. Cardiovasc. Med.

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Cardiometabolic disease refers to the spectrum of chronic conditions that include diabetes, hypertension, atheromatosis, non-alcoholic fatty liver disease, and their long-term impact on cardiovascular health. Histological studies have confirmed several modifications at the tissue level in cardiometabolic disease. Recently, quantitative MR methods have enabled non-invasive myocardial and liver tissue characterization. MR relaxation mapping techniques such as T1, T1ρ, T2 and T2* provide a pixel-by-pixel representation of the corresponding tissue specific relaxation times, which have been shown to correlate with fibrosis, altered tissue perfusion, oedema and iron levels. Proton density fat fraction mapping approaches allow measurement of lipid tissue in the organ of interest. Several studies have demonstrated their utility as early diagnostic biomarkers and their potential to bear prognostic implications. Conventionally, the quantification of these parameters by MRI relies on the acquisition of sequential scans, encoding and mapping only one parameter per scan. However, this methodology is time inefficient and suffers from the confounding effects of the relaxation parameters in each single map, limiting wider clinical and research applications. To address these limitations, several novel approaches have been proposed that encode multiple tissue parameters simultaneously, providing co-registered multiparametric information of the tissues of interest. This review aims to describe the multi-faceted myocardial and hepatic tissue alterations in cardiometabolic disease and to motivate the application of relaxometry and proton-density cardiac and liver tissue mapping techniques. Current approaches in myocardial and liver tissue characterization as well as latest technical developments in multiparametric quantitative MRI are included. Limitations and challenges of these novel approaches, and recommendations to facilitate clinical validation are also discussed.

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“…Distinguishing healthy from diabetic patients using such MRI protocols is fairly straightforward, as diabetic patients have a higher ECV fraction and LGE (Fig. 9c; image 1-8) [324][325][326].…”

Section: Imaging Fibrosis In Diabetesmentioning

confidence: 99%

“…Color-coding: the analysis of manuscripts described in section 4.3 reveal the frequency in which each organ and imaging modality are investigated and used for the detection of fibrosis in diabetes; light blue = low frequency; blue = medium frequency; dark blue = high frequency. All images were adapted with permission[317,323,[325][326][327]333,334].…”

mentioning

confidence: 99%

Therapeutic and diagnostic targeting of fibrosis in metabolic, proliferative and viral disorders

Sofias

Lorenzi

Peña

et al. 2021

Advanced Drug Delivery Reviews

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Myocardial native-T1 times are elevated as a function of hypertrophy, HbA1c, and heart rate in diabetic adults without diffuse fibrosis

Cited by 11 publications

References 38 publications

Hemoglobin A1c in type 2 diabetes mellitus patients with preserved ejection fraction is an independent predictor of left ventricular myocardial deformation and tissue abnormalities

Hemoglobin A1c in type 2 diabetes mellitus patients with preserved ejection fraction is an independent predictor of left ventricular myocardial deformation and tissue abnormalities

Quantitative MRI in cardiometabolic disease: From conventional cardiac and liver tissue mapping techniques to multi-parametric approaches

Therapeutic and diagnostic targeting of fibrosis in metabolic, proliferative and viral disorders

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