Unveiling myocardial microstructure shifts: exploring the impact of diabetes in stable CAD patients through CMR T1 mapping

Gustavo André Boeing Boros; Whady Hueb; Paulo Cury Rezende; Carlos Eduardo Rochitte; Cesar Higa Nomura; Eduardo Gomes Lima; Matheus de Oliveira Laterza Ribeiro; Anderson Roberto Dallazen; Rosa Maria Rahmi Garcia; Jose Antonio Franchini Ramires; Roberto Kalil-Filho

doi:10.1186/s13098-024-01395-9

Unveiling myocardial microstructure shifts: exploring the impact of diabetes in stable CAD patients through CMR T1 mapping

Diabetol Metab Syndr. 2024 Jul 9;16(1):156. doi: 10.1186/s13098-024-01395-9.

Affiliations

¹ Department of Clinical Cardiology - Heart Institute (InCor), University of São Paulo, São Paulo, Brazil.
² Department of Clinical Cardiology - Heart Institute (InCor), University of São Paulo, São Paulo, Brazil. [email protected].
³ Divisão Clínica - Instituto do Coração (InCor), Faculdade de Medicina, Hospital das Clínicas - HCFMUSP, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar 44, AB 1, Sala 114, Cerqueira César, São Paulo, 05403-000, SP, Brazil. [email protected].
⁴ Heart Institute (InCor), University of São Paulo, São Paulo, Brazil.

Abstract

Background: This study investigates myocardial structural changes in stable coronary artery disease (CAD) patients with type 2 diabetes (T2D) using cardiac magnetic resonance (CMR) strain and T1 mapping.

Methods: A total of 155 stable CAD patients underwent CMR examination, including left ventricular (LV) morphology and function assessment, late gadolinium enhancement (LGE), and feature tracking (CMR-FT) for LV global longitudinal, circumferential, and radial strain. T1 mapping with extracellular volume (ECV) evaluation was also performed.

Results: Among the enrolled patients, 67 had T2D. Diabetic patients exhibited impaired LV strain and higher ECV compared to non-diabetics. Multivariate analysis identified T2D as an independent predictor of increased ECV and decreased strain.

Conclusions: CMR-based strain and T1 mapping highlighted impaired myocardial contractility, elevated ECV, and potential interstitial fibrosis in diabetic patients with stable CAD. This suggests a significant impact of diabetes on myocardial health beyond CAD, emphasizing the importance of a comprehensive assessment in these individuals.

Trial registration: http://www.controlled-trials.com/ISRCTN09454308.

Keywords: Cardiac magnetic resonance - feature tracking; Coronary artery disease; Extracellular volume; T1 mapping; Type 2 diabetes mellitus.