The additive effects of type 2 diabetes mellitus on left ventricular deformation and myocardial perfusion in essential h
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Cardiovascular Diabetology
ORIGINAL INVESTIGATION
Open Access
The additive effects of type 2 diabetes mellitus on left ventricular deformation and myocardial perfusion in essential hypertension: a 3.0 T cardiac magnetic resonance study Xue‑Ming Li1,2†, Li Jiang1†, Ying‑Kun Guo3, Yan Ren4, Pei‑Lun Han1, Li‑Qing Peng1, Rui Shi1, Wei‑Feng Yan1 and Zhi‑Gang Yang1*
Abstract Background: Type 2 diabetes mellitus (T2DM) increases the risks of heart failure and mortality in patients with hyper‑ tension, however the underlying mechanism is unclear. This study aims to investigate the impact of coexisting T2DM on left ventricular (LV) deformation and myocardial perfusion in hypertensive individuals. Materials and methods: Seventy hypertensive patients without T2DM [HTN(T2DM−)], forty patients with T2DM [HTN(T2DM+)] and 37 age- and sex-matched controls underwent cardiac magnetic resonance examination. Left ventricular (LV) myocardial strains, including global radial (GRPS), circumferential (GCPS) and longitudinal peak strain (GLPS), and resting myocardial perfusion indices, including upslope, time to maximum signal intensity (TTM), and max signal intensity (MaxSI), were measured and compared among groups by analysis of covariance after adjusting for age, sex, body mass index (BMI) and heart rate followed by Bonferroni’s post hoc test. Backwards stepwise multivari‑ able linear regression analyses were performed to determine the effects of T2DM on LV strains and myocardial perfu‑ sion indices in patients with hypertension. Results: Both GRPS and GLPS deteriorated significantly from controls, through HTN(T2DM−), to HTN(T2DM+) group; GCPS in HTN(T2DM+) group was lower than those in both HTN(T2DM−) and control groups. Compared with con‑ trols, HTN(T2DM−) group showed higher myocardial perfusion, and HTN(T2DM+) group exhibited lower perfusion than HTN(T2DM−) group and controls. Multiple regression analyses considering covariates of systolic blood pressure, age, sex, BMI, heart rate, smoking, indexed LV mass and eGFR demonstrated that T2DM was independently associ‑ ated with LV strains (GRPS: p = 0.002, model R2= 0.383; GCPS: p
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