| ObjectiveUse of cardiac the movies magnetic resonance imaging (Cine-magnetic resonance imaging,Cine-MRI), to assess the type2diabetic patients with left ventricular structure and diastolicfunction changes aimed at understanding the type2diabetic patients with left ventricularstructure and diastolic function of the characteristics of:1)for the assessment of diastolic functionof the clinical type2diabetic patients to provide an objective basis;2)indirect basis and usefulinformation on early prevention of diabetes in patients with diastolic function insufficiency.MethodsCollected in March2011June2011Tai Yuan Central Hospital Department of Cardiology,Endocrinology,60cases involved in the wards and outpatient diagnosed with diabetes, accordingto with or without coronary heart disease is divided into coronary heart disease, coronary heartdisease two groups,30cases; select Tai Yuan Central Hospital Department of Cardiology,coronary heart disease diagnosed by clinical history, laboratory tests to check but withoutdiabetes were30cases, and the other in Tai Yuan City Centre Hospital Medical Center selectedwithout diabetes, coronary heart disease history, ECG indicators of normal healthy volunteers,30cases in the control group. All subjects with no thyroid, kidney and other system and otherserious diseases; MR imaging contraindications; claustrophobia and other physical discomfortduring the examination. German Siemens Sonata,1.5T magnetic resonance scanner and adedicated cardiac phased array coil, ECG and respiratory gating technology and true FISPsequence sagittal line of study, the two chambers, three chamber, four chamber, cover the bottomof my heart to the apex of the left ventricular short axis film image for the wall motion score andleft ventricular short axis scanning. By Siemens cardiac function measurementsoftware(Argus)for measurement of cardiac function, left ventricular outer membrane profile,semi-automatic tracings will be surrounded by the blood pool area stack up (papillary musclecontains included), and calculated left ventricular end-systolic volume(end systole volume, ESV),end diastole volume, end-diastolic volume(EDV), peak filling time(time of peak filling, TPF),peak filling rate(peak filling rate, PFR) and wall thickening(TN), each cardiac functionindicators are repeated measurements, averaged as a measurement value, and draw theappropriate time-volume curve and time-the change rate of left ventricular volume curve.Results1. Proportionality test:Diabetic patients with coronary heart disease group, diabetic group, coronary heart disease group, normal control group and interclass compared with male to female ratio, average age,smoking, drinking than height, weight, body mass index (body mass index, BMI), blood pressureand blood lipids constitute a match, there was no significant difference (p>0.05).2. Cardiac function compared1) diastolic function:(1)PFR: the main effects of diabetic factors was statistically significant,patients with diabetes PFR values lower than non-diabetic patients(F=21.878,P<0.01),the maineffect of the factors of coronary heart disease was statistically significant, coronary heart diseasepatients with PFR values lower than the non-coronary heart disease patients(F=20.787,P<0.01),but the interaction between the two factors was not statistically significant(F=2.364,P=0.127).(2)TPFR: the main effects of diabetic factors was statistically significant, patients with diabetesTPFR values than non-diabetic patients(F=9.003,P=0.003), coronary heart disease factors, themain effect was statistically significant, in patients with coronary heart disease TPFR valuehigher than the non-coronary heart disease patients(F=7.678,P=0.007), but the interactionbetween the two factors was not statistically significant(F=0.006,P=0.938).2) cardiac contractile function:(1) EF: the main effects of diabetic factors not statisticallysignificant (F=3.709,P=0.057), statistically significant main effect of coronary heart diseasefactors, coronary heart disease in patients with EF values lower than the non-crown heart diseasepatients (F=79.984,P<0.01), but the interaction between the two factors was statisticallysignificant (F=3.591,P=0.061).(2) SV: the main effect of the factors of diabetes was statisticallysignificant (F=3.136,P=0.079), statistically significant main effect of factors with coronary arterydisease, coronary heart disease in patients with SV value is lower than the non-coronary heartdisease patients (F=6.211,P=0.014), and the interaction between the two factors was statisticallysignificant, when the diabetic factors allows patients with coronary artery disease SV value wasfurther reduced(F=8.481,P=0.005).(3) CO: the main effects of diabetic factors not statisticallysignificant(F=2.955, P=0.088), statistically significant main effect of factors with coronaryartery disease, coronary heart disease in patients with CO values lower than the non-coronaryheart disease patients (F=6.145P=0.015), but the interaction between the two factors wasstatistically significant (F=3.851, P=0.052).3) Left ventricular wall thickening:(1) the base: the main effects of diabetic factors notstatistically significant (F=1.030, P=0.312), coronary heart disease factors, the main effect is notstatistically significant (F=79.984P<0.01), but the interaction between the two factors wasstatistically significant (F=1.623, P=0.205).(2) the middle of the Ministry: the main effects ofdiabetic factors was statistically significant, patients with diabetes pars intermediate wallthickening rate in the non-diabetic patients (F=5.751, P=0.018), no significant main effect ofcoronary heart disease factors (F=0.329, P=0.567), and the interaction between the two factors was statistically significant when the presence of coronary heart disease factors allows patients with diabetes pars intermediate wall thickening was further increased (F=8.481, P=0.005).3) the apex:the main effects of diabetic factors not statistically significant (F=0.050, P=0.823), statistically significant main effect of factors with coronary artery disease, coronary heart disease in patients with apical wall thickening rate lower than the non-crown heart disease patients (F=19.093, P<0.01), but the interaction between the two factors was statistically significant(F=2.570, P=0.112).3. Myocardial massMMS:There were significant main effects of diabetic factors ventricular mass in diabetic patients than non-diabetic patients (F=8.252, P=0.005), the main effect of coronary heart disease factors are statistically significant, ventricular mass in patients with coronary heart disease than non-patients with coronary heart disease (F=8.850, P=0.004), and the interaction between the two factors was statistically significant, further increase in diabetes factors enable the patients with coronary artery disease MMS value (F=15.170, P<0.01).ConclusionCardiac cine MRI and true FISP sequence due to the high temporal resolution, clear images and accurate measurement of left ventricular function measured "gold standard". Type2DM patients with diastolic dysfunction occurs earlier than systolic dysfunction, and type2diabetes is an independent factor affecting the change in left ventricular diastolic function. Increased left ventricular structural changes and functional disorders and diabetic cardiovascular disease risk factors diabetes, intensive glucose control has an important significance for the prevention and mitigation of diabetic cardiovascular disease. |
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