Impact of diabetes mellitus on right ventricular dysfunction and ventricular interdependence in hypertensive patients with heart failure with reduced ejection fraction assessed via 3.0 T cardiac MRI

• Published in: Cardiovascular diabetology 2024-10, Vol.23 (1), p.375-10, Article 375
• Main Authors: Zhang, Ge, Shi, Rui, Li, Xue-Ming, Yan, Wei-Feng, Xu, Hua-Yan, Li, Yuan, Guo, Ying-Kun, Shi, Ke, Yang, Zhi-Gang
• Format: Article
• Language: English
• Subjects: Aged; Comorbidity; Diabetes mellitus; Diabetes Mellitus - epidemiology; Diabetes Mellitus - physiopathology; Female; Heart Failure - diagnostic imaging; Heart Failure - physiopathology; Heart failure with reduced ejection fraction; Humans; Hypertension; Hypertension - complications; Hypertension - diagnosis; Hypertension - diagnostic imaging; Hypertension - epidemiology; Hypertension - physiopathology; Magnetic Resonance Imaging; Magnetic Resonance Imaging, Cine; Male; Middle Aged; Predictive Value of Tests; Retrospective Studies; Right ventricle strain; Risk Factors; Stroke Volume; Ventricular Dysfunction, Right - diagnostic imaging; Ventricular Dysfunction, Right - etiology; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Left; Ventricular Function, Right; Ventricular interdependence
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-024-02472-z

Hypertension (HTN) and diabetes mellitus (DM) are two common comorbidities of heart failure with reduced ejection fraction (HFrEF), each of which can cause right ventricular (RV) dysfunction. The aim of this study was to investigate the impact of DM on RV dysfunction and ventricular interdependence in hypertensive HFrEF patients via cardiac magnetic resonance imaging (MRI) feature tracking. This study included 249 patients with HFrEF: 77 HFrEF controls, 97 with hypertensive HFrEF (HTN-HFrEF [DM-]) and 75 with hypertensive HFrEF and comorbid DM (HTN-HFrEF [DM+]). The cardiac MRI-derived biventricular global radial (GRS), circumferential (GCS) and longitudinal (GLS) peak strains were obtained and compared among the groups. Multivariable linear regression and mediation analyses were used to evaluate the effects of DM and left ventricular (LV) strain on RV strain. The biventricular GLS and GLS of segments 8, 9 and 14 of the interventricular septum (IVS) decreased gradually from the HFrEF control group to the HTN-HFrEF (DM-) group to the HTN-HFrEF (DM+) group (all P