CMR Quantitative Study Of Left Atrial And Bi-ventricular Myocardial Strains In Patients With Type 2 Diabetes

Objective: Type 2 diabetes mellitus(T2DM)can cause diabetic cardiomyopathy(DCM),which is one of the main complications of poor prognosis.Most T2 DM patients are often accompanied by hypertension(HT),when both are present,the risk of cardiovascular death is significantly higher than that of normal people.Our aim was to assess left atrial(LA),right ventricular(RV)and left ventricular(LV)strain in T2 DM patients without and with hypertension(T2DM-HT)using cardiac magnetic resonance feature-tracking(CMR-FT)and the underlying relationships with clinical parameters.Methods: This study subjects were divided into 3 groups: T2 DM group without hypertension(27 cases),T2DM-HT group(23 cases),and control group(31 cases).LA,LV and RV strain were evaluated using CMR-FT.The clinical and laboratory parameters of patients were collected.Results: No signifcant diferences were observed in LV global radial strain(LVGRS),LV global circumferential strain(LVGCS),LV global longitudinal(LVGLS)among the 3 groups.The T2 DM patients had reduced LA global circumferential strain(LAGCS),radial strain(LAGRS),longitudinal strain(LAGLS)and right ventricular longitudinal strain(RVGLS)compared with the controls(LAGCS: 27.2 ± 2.1% vs33.5 ± 2.4%;LAGRS:-28.6 ± 1.1% vs-31.9 ± 1.3%;LAGLS: 24.3 ± 1.3% vs31.4±1.5;RVGLS:-21.4 ± 1.2% vs-26.3 ± 1.1%,p<0.05 for all).The T2DM-HT patients had greater LAGCS,LAGRS and LAGLS compared with the T2 DM patients(LAGCS: 40.4 ± 3.8% vs 27.2 ± 2.1%;LAGRS:-36.8 ± 2.0% vs-28.6 ± 1.1%;LAGLS: 32.3 ± 2.4% vs 24.3 ± 1.3%,p<0.05 for all).In the multivariable stepwise analysis,LAGCS was correlated with the microalbuminuria levels(standardized β=-0.289,p=0.021),and LAGCS,LAGRS and LAGLS were correlated with diuretic treatment in the diabetic patients(standardized β=0.440,-0.442,and 0.643,p<0.05 for all).Conclusions: CMR-FT may be considered a promising tool for the early detection of abnormal LA and RV myocardial strain.LA and RV strain values are impaired in T2 DM patients.The amelioration of LA strain might be associated with hypertensive compensation or antihypertensive treatment,which requires to be confirmed in larger trials.