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Cardiac magnetic resonance T1 mapping for evaluating myocardial fibrosis in patients with type 2 diabetes mellitus: correlation with left ventricular longitudinal diastolic dysfunction

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Abstract

Objectives

We aimed to evaluate myocardial fibrosis using cardiac magnetic resonance (CMR) T1 mapping in type 2 diabetes mellitus (T2DM) patients and investigate the association between left ventricular (LV) subclinical myocardial dysfunction and myocardial fibrosis.

Methods

The study included 37 short-term (≤ 5 years) and 44 longer-term (> 5 years) T2DM patients and 41 healthy controls. The LV global strain parameters and T1 mapping parameters were compared between the abovementioned three groups. The association of T1 mapping parameters with diabetes duration, in addition to other risk factors, was determined using multivariate linear regression analysis. The correlation between LV strain parameters and T1 mapping parameters was evaluated using Pearson’s correlation.

Results

The peak diastolic strain rates (PDSRs) were significantly lower in longer-term T2DM patients compared to those in healthy subjects and short-term T2DM patients (p < 0.05). The longitudinal peak systolic strain rate and peak strain were significantly lower in the longer-term T2DM compared with the short-term T2DM group (p < 0.05). The extracellular volumes (ECVs) were higher in both subgroups of T2DM patients compared with control subjects (all p < 0.05). Multivariate linear regression analysis showed that diabetes duration was independently associated with ECV (β = 0.413, p < 0.001) by taking covariates into account. Pearson’s analysis showed that ECV was associated with longitudinal PDSR (r = − 0.441, p < 0.001).

Conclusion

T1 mapping could detect abnormal myocardial fibrosis early in patients with T2DM, which can cause a decline in the LV diastolic function.

Key Points

• CMR T1 mapping could detect abnormal myocardial fibrosis early in patients with T2DM.

• The diabetes duration was independently associated with ECV.

• Myocardial fibrosis can cause a decline in the LV diastolic function in T2DM patients.

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Abbreviations

CMR:

Cardiac magnetic resonance

ECV:

Extracellular volume

LVEF:

Left ventricular ejection fraction

PDSR:

Peak diastolic strain rate

PS:

Peak strain

PSSR:

Peak systolic strain rate

T2DM:

Type 2 diabetes mellitus

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Funding

This work was supported by the National Natural Science Foundation of China (82102022, 82120108015, 81971586, 81771887, 81471722), 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYGD18013).

Author information

Author notes

  1. Xi Liu and Yue Gao contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China

    Xi Liu, Yue Gao, Chun-Chao Xia, Rui Shi, Li Jiang, Meng-Ting Shen, Wan-Lin Peng, Wen-Lei Qian & Zhi-Gang Yang

  2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, No.52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China

    Xi Liu

  3. Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# South Renmin Road, Chengdu, 610041, Sichuan, China

    Ying-Kun Guo & Lin-Jun Xie

  4. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China

    Ming-Yan Deng, Li-Ling Deng & Yan Ren

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  1. Xi Liu
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Correspondence to Zhi-Gang Yang.

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The scientific guarantor of this publication is Dr. Zhi-Gang Yang.

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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 (Yue Gao) has significant statistical expertise, and no complex statistical methods were necessary for this paper.

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

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• prospective

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• performed at one institution

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Liu, X., Gao, Y., Guo, YK. et al. Cardiac magnetic resonance T1 mapping for evaluating myocardial fibrosis in patients with type 2 diabetes mellitus: correlation with left ventricular longitudinal diastolic dysfunction. Eur Radiol 32, 7647–7656 (2022). https://doi.org/10.1007/s00330-022-08800-9

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