Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes

• Published in: Journal of cardiovascular magnetic resonance 2024-12, p.101132, Article 101132
• Main Authors: Yeo, Jian L, Abhishek Dattani, Bilak, Joanna M, Wood, Alice L, Athithan, Lavanya, Deshpande, Aparna, Singh, Anvesha, Arnold, J Ranjit, Brady, Emer M, Adlam, David, Biglands, John D, Kellman, Peter, Xue, Hui, Yates, Thomas, Davies, Melanie J, Gulsin, Gaurav S, McCann, Gerry P
• Format: Article
• Language: English
• Subjects: cardiovascular magnetic resonance; coronary microvascular dysfunction; myocardial perfusion; Type 2 diabetes
• ISSN: 1097-6647; 1532-429X; 1532-429X
• DOI: 10.1016/j.jocmr.2024.101132

Coronary microvascular dysfunction (CMD) is a significant complication in type 2 diabetes (T2D) and may be more common in women. We aimed to evaluate the sex differences and sex-specific clinical determinants of CMD in adults with T2D without prevalent cardiovascular disease. Single center pooled analysis of four prospective studies comparing asymptomatic people with T2D and controls. All subjects underwent comprehensive cardiovascular phenotyping with myocardial perfusion reserve (MPR) quantified with perfusion MRI. Participants with silent coronary disease were excluded. Multivariable linear regression was performed to identify determinants of MPR with an interaction term for sex. Four-hundred and seventy-nine T2D (age 57 ± 11y, 42% women) were compared with 116 controls (age 53 ± 11y, 41% women). Men with T2D, but not women, demonstrated worse systolic function and higher extra-cellular volume fraction than controls. MPR was significantly lower in T2D than controls (women, 2.6 ± 0.9 vs. 3.3 ± 1.0, p