Effects of Diabetes Mellitus on Left Ventricular Function and Deformation in Patients with Restrictive Cardiomyopathies: A 3.0T CMR Feature Tracking Study

Abstract

Abstract Background Diabetes mellitus (DM) is the most common metabolic disease worldwide and a major risk factor for adverse cardiovascular events, while the additive effects of DM on left ventricular (LV) deformation in restrictive cardiomyopathy (RCM) cohort remain unclear. Accordingly, we aimed to investigate the additive effects of DM on LV deformation in patients with RCM. Materials and methods One hundred thirty-six RCM patients without DM [RCM(DM−)], 46 with DM [RCM (DM+)] and 66 age- and sex-matched control subjects who underwent cardiac magnetic resonance (CMR) scanning were included. LV function, late gadolinium enhancement (LGE) type and LV global peak strains (including radial, circumferential and longitudinal directions) were measured. The determinant of reduced LV global myocardial strain for all RCM patients was assessed using multivariable linear regression analyses. The receiver operating characteristic curve (ROC) was performed to illustrate the relationship between DM and decreased LV deformation. Results Compared with normal controls, both RCM (DM −) and RCM(DM+) patients presented increased LV end-diastolic index and end-systolic volume index and decreased LV ejection fraction. LV GPS in all three directions and longitudinal PDSR progressively declined from the normal controls to the RCM(DM−) group to the RCM(DM+) group (all p < 0.05). DM was an independent determinant of impaired LV GPS in the radial, circumferential and longitudinal directions and longitudinal PDSR (β =−0.217, 0.176, 0.253,and − 0.263, all p < 0.05) in RCM patients. The multiparameter combination including DM showed an AUC with 0.81(95% CI = 0.75–0.87) to predict decreased LV GLPS and an AUC of 0.69 (95% CI = 0.62–0.76) to predict decreased LV longitudinal PDSR. Conclusions DM had an additive deleterious effect on LV dysfunction in patients with RCM, especially diastolic dysfunction in RCM patients, indicating the importance of early identification and initiation of treatment of DM in patients with RCM.