Adenosine stress CMR T1-mapping detects early microvascular dysfunction in patients with type 2 diabetes mellitus without obstructive coronary artery disease

Autor: Eylem Levelt, Stefan K. Piechnik, Alexander Liu, Rohan S. Wijesurendra, Masliza Mahmod, Rina Ariga, Jane M. Francis, Andreas Greiser, Kieran Clarke, Stefan Neubauer, Vanessa M. Ferreira, Theodoros D. Karamitsos
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Journal of Cardiovascular Magnetic Resonance, Vol 19, Iss 1, Pp 1-10 (2017)
Druh dokumentu: article
ISSN: 1532-429X
DOI: 10.1186/s12968-017-0397-8
Popis: Abstract Background Type 2 diabetes mellitus (T2DM) is associated with coronary microvascular dysfunction in the absence of obstructive coronary artery disease (CAD). Cardiovascular magnetic resonance (CMR) T1-mapping at rest and during adenosine stress can assess coronary vascular reactivity. We hypothesised that the non-contrast T1 response to vasodilator stress will be altered in patients with T2DM without CAD compared to controls due to coronary microvascular dysfunction. Methods Thirty-one patients with T2DM and sixteen matched healthy controls underwent CMR (3 T) for cine, rest and adenosine stress non-contrast T1-mapping (ShMOLLI), first-pass perfusion and late gadolinium enhancement (LGE) imaging. Significant CAD (>50% coronary luminal stenosis) was excluded in all patients by coronary computed tomographic angiography. Results All subjects had normal left ventricular (LV) ejection and LV mass index, with no LGE. Myocardial perfusion reserve index (MPRI) was lower in T2DM than in controls (1.60 ± 0.44 vs 2.01 ± 0.42; p = 0.008). There was no difference in rest native T1 values (p = 0.59). During adenosine stress, T1 values increased significantly in both T2DM patients (from 1196 ± 32 ms to 1244 ± 44 ms, p
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