Impact of myocardial scars on left ventricular deformation in type 2 diabetes mellitus after myocardial infarction by contrast-enhanced cardiac magnetic resonance.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101147637 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2840 (Electronic) Linking ISSN: 14752840 NLM ISO Abbreviation: Cardiovasc Diabetol Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2002-
    • Subject Terms:
      Contrast Media* ; Magnetic Resonance Imaging, Cine* ; Organometallic Compounds* ; Ventricular Function, Left*; Diabetes Mellitus, Type 2/*complications ; Diabetic Cardiomyopathies/*diagnostic imaging ; Meglumine/*analogs & derivatives ; Myocardial Infarction/*diagnostic imaging ; Myocardium/*pathology; Adult ; Aged ; Diabetes Mellitus, Type 2/diagnosis ; Diabetic Cardiomyopathies/etiology ; Diabetic Cardiomyopathies/pathology ; Diabetic Cardiomyopathies/physiopathology ; Female ; Heart Disease Risk Factors ; Humans ; Male ; Middle Aged ; Myocardial Infarction/etiology ; Myocardial Infarction/pathology ; Myocardial Infarction/physiopathology ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Risk Assessment
    • Abstract:
      Background: Type 2 diabetes mellitus (T2DM) is a major risk factor for coronary artery disease and myocardial infarction (MI). The interaction of diabetic cardiomyopathy and MI scars on myocardial deformation in T2DM patients is unclear. Therefore, we aimed to evaluate myocardial deformation using cardiac magnetic resonance (CMR) in T2DM patients with previous MI and investigated the influence of myocardial scar on left ventricular (LV) deformation.
      Methods: Overall, 202 T2DM patients, including 46 with MI (T2DM(MI+)) and 156 without MI (T2DM(MI-)), and 59 normal controls who underwent CMR scans were included. Myocardial scars were assessed by late gadolinium enhancement. LV function and deformation, including LV global function index, LV global peak strain (PS), peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR), were compared among these groups. Correlation and multivariate linear regression analyses were used to investigate the relationship between myocardial scars and LV deformation.
      Results: Decreases were observed in LV function and LV global PS, PSSR, and PDSR in the T2DM(MI+) group compared with those of the other groups. Reduced LV deformation (p < 0.017) was observed in the T2DM(MI+) group with anterior wall infarction. The increased total LV infarct extent and infarct mass of LV were related to decreased LV global PS (radial, circumferential, and longitudinal directions; p < 0.01) and LV global PSSR (radial and circumferential directions, p < 0.02). Multivariate analysis demonstrated that NYHA functional class and total LV infarct extent were independently associated with LV global radial PS (β =  - 0.400 and β =  - 0.446, respectively, all p < 0.01; model R 2  = 0.37) and circumferential PS (β = 0.339 and β = 0.530, respectively, all p < 0.01; model R 2  = 0.41), LV anterior wall infarction was independently associated with LV global longitudinal PS (β = 0.398, p = 0.006).
      Conclusions: The myocardial scarring size in T2DM patients after MI is negatively correlated with LV global PS and PSSR, particularly in the circumferential direction. Additionally, different MI regions have different effects on the reduction of LV deformation, and relevant clinical evaluations should be strengthened.
      (© 2021. The Author(s).)
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    • Grant Information:
      821201080 National Natural Science Foundation of China; 81971586 National Natural Science Foundation of China; 81771887 National Natural Science Foundation of China; 81471722 National Natural Science Foundation of China
    • Contributed Indexing:
      Keywords: Cardiac magnetic resonance; Diabetic cardiomyopathy; Myocardial infarction; Myocardial scar
    • Accession Number:
      0 (Contrast Media)
      0 (Organometallic Compounds)
      15G12L5X8K (gadobenic acid)
      6HG8UB2MUY (Meglumine)
    • Publication Date:
      Date Created: 20211026 Date Completed: 20220131 Latest Revision: 20220131
    • Publication Date:
      20221213
    • Accession Number:
      PMC8547068
    • Accession Number:
      10.1186/s12933-021-01407-2
    • Accession Number:
      34696783