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Jamal Nasir Khan, Emma Gwyn Wilmot, Melanie Leggate, Anvesha Singh, Thomas Yates, Myra Nimmo, Kamlesh Khunti, Mark A. Horsfield, John Biglands, Patrick Clarysse, Pierre Croisille, Melanie Davies, Gerry Patrick McCann, Subclinical diastolic dysfunction in young adults with Type 2 diabetes mellitus: a multiparametric contrast-enhanced cardiovascular magnetic resonance pilot study assessing potential mechanisms, European Heart Journal - Cardiovascular Imaging, Volume 15, Issue 11, November 2014, Pages 1263–1269, https://doi.org/10.1093/ehjci/jeu121
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Abstract
To assess the cardiac, vascular, anthropometric, and biochemical determinants of subclinical diastolic dysfunction in younger adults with Type 2 diabetes mellitus (T2DM) using multiparametric contrast-enhanced cardiovascular magnetic resonance (CMR) imaging.
Twenty adults <40 years with T2DM [mean age 31.8(6.6) years, T2DM duration 4.7(4.0) years] and 20 age and sex-matched controls [10 obese non-diabetic controls and 10 lean controls (LC)] were studied. Cardiac volumes and function, circumferential strain and peak early diastolic strain rate (PEDSR), myocardial perfusion reserve, aortic stiffness (distensibility, pulse-wave velocity), focal fibrosis on late gadolinium enhancement, and pre- and post-contrast T1 mapping for contrast agent partition coefficient (subset, n = 26) were determined by CMR. In the T2DM cohort, mean aortic distensibility correlated with PEDSR (r = 0.564, P = 0.023) and diabetes duration correlated inversely with PEDSR (r = −0.534, P = 0.015) on univariate analysis. There was a close association between PEDSR and peak systolic strain (r = −0.580, P = 0.007).
In young adults with T2DM, diabetes duration and aortic distensibility were associated with diastolic dysfunction. Interventional studies are required to assess whether cardiac dysfunction can be reversed in this phenotype of patients.