Prognostic Value of Left Ventricular Longitudinal Function and Myocardial Fibrosis in Patients With Ischemic and Non‐Ischemic Dilated Cardiomyopathy Concomitant With Type 2 Diabetes Mellitus: A 3.0 T Cardiac MR Study

• Published in: Journal of magnetic resonance imaging 2024-01, Vol.59 (1), p.164-176
• Main Authors: Zhang, Hong‐Kai, Du, Yu, Shi, Chun‐Yan, Zhang, Nan, Gao, Hui‐Qiang, Zhong, Yong‐Liang, Wang, Mao‐Zhou, Zhou, Zhen, Gao, Xue‐Lian, Li, Shuang, Yang, Lin, Liu, Tong, Fan, Zhan‐Ming, Sun, Zhong‐Hua, Xu, Lei
• Format: Article
• Language: English
• Subjects: cardiac magnetic resonance; Cardiomyopathies; Cardiomyopathy, Dilated - complications; Cardiomyopathy, Dilated - diagnostic imaging; Contrast Media; Diabetes Mellitus, Type 2 - complications; dilated cardiomyopathy; Fibrosis; Gadolinium; global longitudinal strain rate; Glycated Hemoglobin; Humans; Ischemia; late gadolinium enhancement; Magnetic Resonance Imaging, Cine - methods; Prognosis; Retrospective Studies; type 2 diabetes mellitus; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Function, Left
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.28723

Background Poorly controlled type 2 diabetes mellitus (T2DM) is known to result in left ventricular (LV) dysfunction, myocardial fibrosis, and ischemic/nonischemic dilated cardiomyopathy (ICM/NIDCM). However, less is known about the prognostic value of T2DM on LV longitudinal function and late gadolinium enhancement (LGE) assessed with cardiac MRI in ICM/NIDCM patients. Purpose To measure LV longitudinal function and myocardial scar in ICM/NIDCM patients with T2DM and to determine their prognostic values. Study Type Retrospective cohort. Population Two hundred thirty‐five ICM/NIDCM patients (158 with T2DM and 77 without T2DM). Field Strength/Sequence 3T; steady‐state free precession cine; phase‐sensitive inversion recovery segmented gradient echo LGE sequences. Assessment Global peak longitudinal systolic strain rate (GLPSSR) was evaluated to LV longitudinal function with feature tracking. The predictive value of GLPSSR was determined with ROC curve. Glycated hemoglobin (HbA1c) was measured. The primary adverse cardiovascular endpoint was follow up every 3 months. Statistical Tests Mann–Whitney U test or student's t‐test; Intra and inter‐observer variabilities; Kaplan–Meier method; Cox proportional hazards analysis (threshold = 5%). Results ICM/NIDCM patients with T2DM exhibited significantly lower absolute value of GLPSSR (0.39 ± 0.14 vs. 0.49 ± 0.18) and higher proportion of LGE positive (+) despite similar LV ejection fraction, compared to without T2DM. LV GLPSSR was able to predict primary endpoint (AUC 0.73) and optimal cutoff point was 0.4. ICM/NIDCM patients with T2DM (GLPSSR