Role of microvascular dysfunction in left ventricular dysfunction in type 2 diabetes mellitus

医学 心脏病学 内科学 冠状动脉血流储备 糖尿病 无症状的 糖尿病性心肌病 舒张期 人口 冠状动脉疾病 心肌病 心力衰竭 血压 内分泌学 环境卫生
作者
Amera Halabi,Mark Nolan,Elizabeth Potter,Leah Wright,Atef Asham,Thomas H. Marwick
出处
期刊:Journal of Diabetes and Its Complications [Elsevier BV]
卷期号:35 (5): 107907-107907 被引量:4
标识
DOI:10.1016/j.jdiacomp.2021.107907
摘要

Although microvascular disease (mVD) has been linked to poor cardiovascular outcomes in diabetes mellitus, the contribution of mVD to diabetic cardiomyopathy (DC) is unexplored. We investigated whether LV systolic and diastolic dysfunction is associated with mVD in T2DM.We recruited 32 asymptomatic patients with T2DM (age 71 ± 4 years, 31% females) from a community-based population. All underwent a comprehensive echocardiogram at baseline including assessment of global longitudinal strain (GLS) and diastolic function. Adenosine stress perfusion on cardiac magnetic resonance imaging (CMR) was performed in all patients. Coronary sinus flow (CSF) was measured offline at rest and peak stress with coronary flow reserve (CFR) calculated as the ratio of global stress and rest CSF.Resting CSF was reduced in 15 (47%) compared to 4 (13%) with adenosine-stress (p = 0.023). Overall, CFR was observed to be reduced in the cohort (2.38 [IQR 2.20]). Abnormal CFR was not associated with diabetes duration of ≥10 years or poor glycaemic control. CFR was not associated with abnormal GLS (OR 1.04 [95% CI 0.49, 2.20], p = 0.93). However, a modest negative correlation was observed with e' and CFR (r = -0.49, p = 0.004).This pilot study did not show correlation between subclinical systolic dysfunction and a novel MRI biomarker of microvascular disease. However, there was a weak correlation with myocardial relaxation. Confirmation of these findings in larger studies is indicated.
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