Distinct non-ischemic myocardial late gadolinium enhancement lesions in patients with type 2 diabetes
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ORIGINAL INVESTIGATION
Cardiovascular Diabetology Open Access
Distinct non‑ischemic myocardial late gadolinium enhancement lesions in patients with type 2 diabetes Annemie Stege Bojer1,2* , Martin Heyn Sørensen1,2, Niels Vejlstrup3, Jens P. Goetze4, Peter Gæde1,2 and Per Lav Madsen5,6
Abstract Background: Cardiovascular magnetic resonance imaging (CMR) have described localised non-ischemic late gadolinium enhancement (LGE) lesions of prognostic importance in various non-ischemic cardiomyopathies. Ischemic LGE lesions are prevalent in diabetes (DM), but non-ischemic LGE lesions have not previously been described or systematically studied in DM. Methods: 296 patients with type 2 DM (T2DM) and 25 sex-matched control subjects underwent echocardiography and CMR including adenosine-stress perfusion, T1-mapping and LGE. Results: 264 patients and all control subjects completed the CMR protocol. 78.4% of patients with T2DM had no LGE lesions; 11.0% had ischemic LGE lesions only; 9.5% had non-ischemic LGE lesions only; and 1.1% had both one ischemic and one non-ischemic lesion. The non-ischemic LGE lesions were situated mid-myocardial in the basal lateral or the basal inferolateral part of the left ventricle and the affected segments showed normal to high wall thickness and normal contraction. Patients with non-ischemic LGE lesions in comparison with patients without LGE lesions had increased myocardial mass (150 ± 34 vs. 133 ± 33 g, P = 0.02), average E/e’(9.9 IQR8.7–12.6 vs. 8.8 IQR7.4–10.7, P = 0.04), left atrial maximal volume (102 IQR84.6–115.2 vs. 91 IQR75.2–100.0 mL, P = 0.049), NT-proBNP (8.9 IQR5.9– 19.7 vs. 5.9 IQR5.9–10.1 µmol/L, P = 0.02) and high-sensitive troponin (15.6 IQR13.0–26.1 vs. 13.0 IQR13.0–14.6 ng/L, P = 0.007) and a higher prevalence of retinopathy (48 vs. 25%, P = 0.009) and autonomic neuropathy (52 vs. 30.5%, P = 0.005). Conclusion: A specific LGE pattern with lesions in the basal lateral or the basal inferolateral part of the left ventricle was found in patients with type 2 diabetes. Trial registration https://www.clinicaltrials.gov. Unique identifier: NCT02684331. Keywords: Diabetes type 2, Cardiovascular magnetic resonance imaging (MRI), Risk factors, Late gadolinium enhancement, Diabetes complications
*Correspondence: [email protected] 1 Department of Cardiology and Endocrinology, Slagelse Hospital, Ingemannsvej 32, 4200 Slagelse, Region Zealand, Denmark Full list of author information is available at the end of the article
Background For decades it has been known that angiopathy, as seen in patients with diabetes (DM) differs from what is seen in other patients [1], and the cardiomyopathy associated with DM has increasingly been recognised to be a specific entity. People with DM, compared to people without, have a three-fold increased risk of death from cardiovascular causes [2] and a two- (men) to five-fold
© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and
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