| Objective: There are a large number of patients with type 2 diabetes mellitus(T2DM)in China.A series of complications caused by T2 DM have adverse effects on the structure and function of various organs and the clinical prognosis of patients,among which heart failure caused by left ventricular dysfunction has the most serious effect on prognosis.Increased blood lipids caused by metabolic abnormalities also increase the risk of cardiovascular disease in patients with T2 DM.Cardiac magnetic resonance(CMR)has the characteristics of good resolution,multi-plane and multi-parameter imaging.CMR can accurately measure cardiac function,16-segment ventricular wall thickness and atrioventricular dimension,quantitatively evaluate myocardial fibrosis,myocardial perfusion,myocardial activity and myocardial metabolism.Compared with the changes of left ventricular wall thickness and dimension in patients with T2 DM,there are more reports about left ventricular dysfunction caused by T2 DM.In order to find the clinical indexes that had significant influence on left ventricular structure and function,this study used CMR to evaluate the changes of left ventricular wall thickness,dimension and function in patients with T2 DM,and to analyze the correlation between left ventricular structural changes,functional abnormalities and clinical data.Methods: In this study,23 patients with T2DM(T2DM group)and 22 healthy subjects(control group)underwent CMR scans by Siemens 3.0T MR.The left ventricular short-axis cine and four-chamber long-axis cine images were processed by Argus software,the indexes of left ventricular function,wall thickness and dimension were obtained.The differences of the above-mentioned indexes between two groups were compared,and the correlation between partial structure and function indexes and clinical data in the T2 DM group was analyzed.Results:(1)The levels of fasting blood glucose(F=25.363,P < 0.001),glycosylated hemoglobin(Z=-5.752,P < 0.001),total cholesterol(Z=-2.407,P=0.016),triglyceride(Z=-3.202,P=0.001),apolipoprotein B(F=6.522,P < 0.001)and free fatty acids(Z=-2.657,P=0.008)in T2 DM group were higher than in control group,these differences have statistically significant.(2)CMR results show that,the left ventricular end-diastolic dimension(F=0.389,P=0.024)and end-systolic dimension(F=2.783,P=0.025)were larger,the left ventricular inferior wall thickness at apical level(F=1.064,P=0.018)was thinner in T2 DM group than in control group,these differences have statistically significant.(3)CMR results show that,EF(F=0.854,P=0.001)was decreased,ESV(F=0.502,P=0.001)and ESVI(F=1.553,P=0.002)were increased,SVI(Z=-2.339,P=0.019)and CI(Z=-2.543,P=0.011)were reduced,and PFR/LVEDV(F=6.564,P=0.008)was decreased in the T2 DM group than in control group,these differences have statistically significant.(4)In T2 DM group,the duration of T2 DM has significantly negative correlation with LVESV(r =-0.517,P=0.012),apolipoprotein B has significantly negative correlation with apical left ventricular inferior wall thickness(r =-0.435,P= 0.038),and sex was significantly correlated with LVESD(r =-0.495,P= 0.016).Conclusions:(1)Hyperlipidemia is more common in patients with T2 DM than in normal subjects.(2)Based on the results measured by CMR,T2 DM can cause the decrease of left ventricular function,the enlargement of left ventricular dimension and the thinning of apical horizontal inferior wall.(3)the increase of disease course is one of the factors affecting the decrease of left ventricular systolic function.(4)The increase of apolipoprotein B leads to the thinning of left ventricular wall thickness and has potential value in predicting the change of left ventricular wall thickness. |
PDF Full Text Request