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Subclinical changes in MRI-determined right ventricular volumes and function in subjects with prediabetes and diabetes

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Abstract

Objectives

The aim of this study was to assess subclinical changes in right ventricular volumes and function in subjects with prediabetes and diabetes and controls without a history of cardiovascular disease.

Methods

Data from 400 participants in the KORA FF4 study without self-reported cardiovascular disease who underwent 3-T whole-body MRI were obtained. The right ventricle was evaluated using the short axis and a four-chamber view. Diabetes was defined according to WHO criteria. Associations between glucose tolerance and right ventricular parameters were assessed using multivariable adjusted linear regression models.

Results

Data from 337 participants were available for analysis. Of these, 43 (13%) had diabetes, 87 (26%) had prediabetes, and 207 (61%) were normoglycaemic controls. There was a stepwise decrease in right ventricular volumes in men with prediabetes and diabetes in comparison with controls, including right ventricular end-diastolic volume (β = −20.4 and β = −25.6, respectively; p ≤ 0.005), right ventricular end-systolic volume (β = −12.3 and β = −12.7, respectively; p ≤ 0.037) and right ventricular stroke volume (β = −8.1 and β = −13.1, respectively, p ≤ 0.016). We did not observe any association between prediabetes or diabetes and right ventricular volumes in women or between prediabetes or diabetes and right ventricular ejection fraction in men and women.

Conclusions

This study points towards early subclinical changes in right ventricular volumes in men with diabetes and prediabetes.

Key Points

• MRI was used to detect subclinical changes in right ventricular parameters.

• Diabetes mellitus is associated with right ventricular dysfunction.

• Impairment of right ventricular volumes seems to occur predominantly in men.

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Abbreviations

BMI:

Body mass index

KORA:

Cooperative Health Research in the Region of Augsburg (Kooperative Gesundheitsforschung in der Region Augsburg)

NGT:

Normal glucose tolerance

RVD:

Right ventricular dysfunction

RV-EDV:

Right ventricular end-diastolic volume

RV-EF:

Right ventricular ejection fraction

RV-ESV:

Right ventricular end-systolic volume

RV-SV:

Right ventricular stroke volume

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Funding

This study received funding from the Helmholtz Zentrum München – German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. Furthermore, KORA research was supported by DZHK (Deutsches Zentrum für Herz-Kreislaufforschung – the German Centre for Cardiovascular Research). The KORA-MRI substudy received funding from the German Research Foundation (DFG, Deutsche Forschungsgemeinschaft), and was also supported by an unrestricted research grant from Siemens Healthcare.

Author information

Authors and Affiliations

  1. Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Marchioninistr. 15, 81377, Munich, Germany

    Hannah Patscheider, Roberto Lorbeer, Sigrid Auweter, Anina Schafnitzel, Christian Bayerl, Adrian Curta, Fabian Bamberg & Holger Hetterich

  2. Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany

    Fabian Bamberg

  3. Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre of Environmental Health, Neuherberg, Germany

    Margit Heier, Christa Meisinger & Annette Peters

  4. German Centre for Diabetes Research (DZD e.V.), Neuherberg, Germany

    Annette Peters

  5. German Centre for Cardiovascular Disease Research (DZHK e.V.), Munich, Germany

    Annette Peters

  6. Department of Biometry and Epidemiology, German Diabetes Centre, Duesseldorf, Germany

    Wolfgang Rathmann

  7. KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany

    Margit Heier & Christa Meisinger

Authors
  1. Hannah Patscheider
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  2. Roberto Lorbeer
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  3. Sigrid Auweter
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  4. Anina Schafnitzel
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  5. Christian Bayerl
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  7. Wolfgang Rathmann
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  8. Margit Heier
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  9. Christa Meisinger
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  10. Annette Peters
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  11. Fabian Bamberg
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  12. Holger Hetterich
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Corresponding author

Correspondence to Holger Hetterich.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Holger Hetterich.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohort overlap

Some study subjects or cohorts have been previously reported in papers on the KORA MRI substudy. Those previously published papers included data from all subjects of the present work. However, so far no data on right ventricular parameters has been published, which are the main focus of the present paper.

• Association between MRI-derived hepatic fat fraction and BP in participants without history of cardiovascular disease. Lorbeer R, Bayerl C, Auweter S, Rospleszcz S, Lieb W, Meisinger C, Heier M, Peters A, Bamberg F, Hetterich H.

• Subclinical disease burden as assessed by whole-body MRI in subjects with prediabetes, subjects with diabetes, and normal control subjects from the general population: the KORA-MRI study. Bamberg F, Hetterich H, Rospleszcz S, Lorbeer R, Auweter SD, Schlett CL, Schafnitzel A, Bayerl C, Schindler A, Saam T, Müller-Peltzer K, Sommer W, Zitzelsberger T, Machann J, Ingrisch M, Selder S, Rathmann W, Heier M, Linkohr B, Meisinger C, Weber C, Ertl-Wagner B, Massberg S, Reiser MF, Peters A.

• Feasibility of a three-step magnetic resonance imaging approach for the assessment of hepatic steatosis in an asymptomatic study population. Holger Hetterich, Christian Bayerl, Annette Peters, Margit Heier, Birgit Linkohr, Christa Meisinger, Sigrid Auweter, Stephan A.R.Kannengießer, Harald Kramer, Birgit Ertl-Wagner, Fabian Bamberg

• Pancreatic fat content by magnetic resonance imaging in subjects with prediabetes, diabetes, and controls from a general population without cardiovascular disease. Sophia D. Heber, Holger Hetterich, Roberto Lorbeer, Christian Bayerl, Jürgen Machann, Sigrid Auweter, Corinna Storz, Christopher L. Schlett, Konstantin Nikolaou, Maximilian Reiser, Annette Peters, Fabian Bamberg

Methodology

• retrospective

• cross sectional study

• performed at one institution

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Patscheider, H., Lorbeer, R., Auweter, S. et al. Subclinical changes in MRI-determined right ventricular volumes and function in subjects with prediabetes and diabetes. Eur Radiol 28, 3105–3113 (2018). https://doi.org/10.1007/s00330-017-5185-1

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  • DOI: https://doi.org/10.1007/s00330-017-5185-1

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