Assessment of subclinical left ventricular (LV) myocardial dysfunction in T2DM patients with diabetic peripheral neuropathy: a cardiovascular magnetic resonance study
Authors' conclusion
There was more severe subclinical LV dysfunction in T2DM patients complicated with DPN than those without DPN, suggesting further prospective study with more active intervention in this cohort of patients.
Study context
- Population
- T2D patients with and without diabetic peripheral neuropathy (DPN) and controls undergoing cardiovascular magnetic resonance (CMR); no HF symptoms and LV ejection fraction ≥ 50%
- Participants
- 61 / 130 / 65
- Exposure
- T2D with DPN vs T2D without DPN vs controls
- DPNn = 61
- Without DPNn = 130
- Controlsn = 65reference
- Outcome
- Subclinical LV myocardial dysfunction: non-infarct late gadolinium enhancement (LGE) and LV global strains (PS, PSSR, PDSR) by CMR feature tracking
Methodological detailscardiovascular magnetic resonance feature tracking, age and sex-matched controls
- Cardiovascular magnetic resonance feature tracking
- Age and sex-matched controls
Main finding
As reported in the abstract
LV radial PS, longitudinal PS and longitudinal PDSR
| Group | Value | Longitudinal peak strain (PS) (mean ± SD) | Longitudinal PDSR (median (IQR)) |
|---|---|---|---|
| Controls | mean 36.60 ± 7.24 % | - 15.03 ± 2.52% | 0.89 (0.76, 1.05) 1/s |
| Without DPN | mean 33.57 ± 7.30 % | - 13.39 ± 2.48% | 0.80 (0.71, 0.93) 1/s |
| DPN | mean 30.72 ± 8.68 % | - 11.89 ± 3.02% | 0.77 (0.63, 0.87) 1/s |
Value
Controlsmean 36.60 ± 7.24 %
Without DPNmean 33.57 ± 7.30 %
DPNmean 30.72 ± 8.68 %
Longitudinal peak strain (PS) (mean ± SD)
Controls- 15.03 ± 2.52%
Without DPN- 13.39 ± 2.48%
DPN- 11.89 ± 3.02%
Longitudinal PDSR (median (IQR))
Controls0.89 (0.76, 1.05) 1/s
Without DPN0.80 (0.71, 0.93) 1/s
DPN0.77 (0.63, 0.87) 1/s
- Between Controls and DPN: all p < 0.001 — decreased significantly from controls through without DPN to DPN
Observational data: associations, not effects.
Further findings
| Outcome | DPN | Without DPN | P value |
|---|---|---|---|
| Non-infarct LGE prevalenceDPN vs Without DPN · higher with DPN | 37.7% | 19.2% | P = 0.008 |
LV radial and circumferential PDSR and circumferential PS
- Reduced in both patient groups (all p < 0.05), not different between the two groups (all p > 0.05)
Radial and longitudinal PSSR
- Decreased with DPN (p = 0.006 and 0.003), preserved without DPN (all p > 0.05)
Multivariable association of DPN with LV strain
- Radial and longitudinal PS β (p = 0.014 and 0.003)
- - 3.025 and 1.187
- Radial and longitudinal PDSR β (p = 0.016 and 0.001)
- 0.283 and - 0.086
- Radial PSSR β (p = 0.007)
- - 0.266
- Adjusted for confounders
Original publication
Assessment of subclinical LV myocardial dysfunction in T2DM patients with diabetic peripheral neuropathy: a cardiovascular magnetic resonance study. Cardiovasc Diabetol. Published 24 June 2024. doi:10.
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