Evaluation Of Interaction Between Type 2 Diabetes Mellitus And Pressure Overload On Myocardial Motor Pattern Based On Cardiac MRI

Purpose: To use multiple parameters of cardiovascular magnetic resonance feature tracking analysis(CMR feature-tracking,FT)quantitative assessment of myocardial function in hypertensive with diabetes patients,Certify that diabetes can cause myocardial compensatory capacity or pattern changed,when pressure overloaded was increased.Materials and methods: Prospectively recruited 15 healthy volunteers,37 pure hypertension patients,22 pure diabetes patients and 14 hypertension with diabetes patients,CMR(MAGNETOM Verio 3.0 T,Siemens)was performed.All subjects signed a written informed consent,and underwent a comprehensive clinical evaluation,including blood biochemistry,hemoglobin A1 C and other laboratory examination as well as CMR examination including short axis continuous multi-slice cine,left ventricular long axis cardiac cine,through mitral valve flow velocity cine.Use the special post processing software(cvi 42,Calgary,Canada)to get myocardial strain and diastolic strain rate index.Statistics method mainly use two factor two level factorial design analysis of variance were compared between the four groups of indicators.Results: The groups of volunteer left ventricular ejection fraction(LVEF)(63.13 ± 5.06%),hypertension group LVEF(63.33±5.79%);diabetic group LVEF(61.71 ± 7.30)%,diabetes mellitus with hypertension group LVEF(67.71±6.53)%,Four groups LVEF were in the normal range,the disease group compared with healthy group were not statistically significant.Hypertension group,diabetic group diabetes mellitus with hypertension group E/A different degree reduction in the normal group(F = 3.509,P = 3.509),hypertension group of left ventricular mass increases,left ventricular centripetal remolding(LVMVR = 1.14±0.21)larger than normal group(F= 7.960,P < 0.001).For the index of peak diastolic radial strain rate(PDSRR),Diabetes of main effect has statistical difference(F = 5.768,P = 0.019),Hypertension of main effect was not statistically significant(F = 1.180,P = 0.281),Apparent statistically significant interaction between diabetes and hypertension(F = 8.166,P = 0.005).Pure diabetes could make PDSRR reduce(compared to DM group and volunteer group,P < 0.05),Isolated hypertension may cause PDSRR reduction(hypertension group compared with the volunteer group,P < 0.05).The presence of diabetes and hypertension,the effect was not significant(diabetic hypertensive group compared with hypertension group,P > 0.05).Immediate antagonists of diabetes and hypertension on index of PDSRR.Similarly,The peak diastolic circumferential strain rate(PDSRC)has antagonistic effects of diabetes and hypertension(F = 10.422,P = 0.002).Conclusion: In the simple diabetes and hypertension patients,there is a way of myocardial motion changes in order to ensure the normal ejection capacity,may be a compensatory mechanism for early sub-clinical myocardial diastolic function decreased.Diabetes complicated with hypertension trigger antagonistic effect on myocardial movement,suggesting that the patients with hypertension and diabetes,compensation the ability of myocardium may be reduced,more likely to occur decompensate heart failure.These preliminary results need further follow-up studies to identify.