Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study

• Published in: Cardiovascular diabetology 2020-03, Vol.19 (1), p.42-42, Article 42
• Main Authors: Ng, Ming-Yen, Zhou, Wenli, Vardhanabhuti, Varut, Lee, Chi-Ho, Yu, Esther Yee Tak, Wan, Eric Yuk Fai, Chan, Kit, Yan, Andrew T, Ip, Tai-Pang, Yiu, Kai-Hang, Wintersperger, Bernd J
• Format: Article
• Language: English
• Subjects: Adenosine; Angina pectoris; Angiography; Asymptomatic; Cardiology; Cardiovascular disease; Cardiovascular diseases; Catheters; Clinics; Congestive heart failure; Coronary artery; Coronary vessels; Defects; Diabetes; Diabetes mellitus (non-insulin dependent); High cardiovascular risk; Implants; Ischemia; Medical imaging; Original Investigation; Patients; Performance evaluation; Perfusion; Screening; Stress cardiac magnetic resonance; Type 2 diabetes
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-020-01019-2

Stress cardiovascular magnetic resonance (CMR) to screen for silent myocardial ischaemia in asymptomatic high risk patients with type 2 diabetes mellitus (DM) has never been performed, and its effectiveness is unknown. Our aim was to determine the feasibility of a screening programme using stress CMR by obtaining preliminary data on the prevalence of silent ischaemia caused by obstructive coronary artery disease (CAD) and quantify myocardial perfusion in asymptomatic high risk patients with type 2 diabetes. In this prospective cohort study, we recruited 63 asymptomatic DM patients (mean age 66 years ± 4.4 years; 77.8% male); with Framingham risk score ≥ 20% from 3 sites from June 2017 to August 2018. Normal volunteers were recruited to determine normal global myocardial perfusion reserve index (MPRI). Adenosine stress CMR and global MPRI was performed and measured in all subjects. Positive stress CMR cases were referred for catheter coronary angiography (CCA) with/without fractional flow reserve (FFR) measurements. Positive CCA was defined as an FFR ≤ 0.8 or coronary narrowing ≥ 70%. Patients were followed up for major adverse cardiovascular events. Prevalence is presented as patient numbers and percentage. Mann-Whitney U test was used to compare global MPRI between patients and normal volunteers. 13 patients had positive stress CMR with positive CCA (20.6% of patient population), while 9 patients with positive stress CMR examinations had a negative CCA. 5 patients (7.9%) had infarcts detected of which 2 patients had no stress perfusion defects. 12 patients had coronary artery stents inserted, whilst 1 patient declined stent placement. DM patients had lower global MPRI than normal volunteers (n = 7) (1.43 ± 0.27 vs 1.83 ± 0.31 respectively; p