Comprehensive CMR evaluation including 4D flow-derived E/A vorticity ratio in overweight adults with and without type 2 diabetes mellitus
Authors' conclusion
The present study suggests that the 4D flow CMR-derived E/A vorticity ratio may serve as a potential LV diastolic biomarker, given its capability in differentiating T2D-specific changes and stronger associations with clinical measures as well as CMR and echocardiographic parameters.
Study context
- Population
- Middle-aged participants: lean, overweight without T2D and overweight with uncomplicated T2D
- Participants
- 13 / 37 / 28
- Exposure
- Lean individuals vs overweight controls without T2D vs overweight individuals with uncomplicated T2D
- LIn = 13reference
- CWOn = 37
- T2Dn = 28
- Outcome
- 4D flow CMR diastolic indices (E/A velocity, flow and vorticity ratios)
Methodological details4D flow CMR, age- and sex-similar groups
- 4D flow CMR
- Age- and sex-similar groups
Main finding
As reported in the abstract
- Between LI and CWO: P = 0.029
- Between CWO and T2D: P = 0.025
- Between CWO and T2D: P = 0.031
- Between CWO and T2D: P = 0.034
- Holm-Bonferroni correction for pairwise comparisons
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Cardiorespiratory fitnessCWO vs LI · lower with CWO | P < 0.001 |
| Cardiorespiratory fitnessT2D vs LI · lower with T2D | P < 0.001 |
Cardiorespiratory fitness
- No difference between CWO and T2D
Correlation of E/A vorticity ratio with echocardiographic MV E/A velocity ratio
- Spearman's rho (adjusted for age and sex), 95% CI 0.07-0.60, P = 0.010
- 0.35
Independent determinants of E/A vorticity ratio (multivariate regression)
- Age, β (P = 0.001)
- - 0.014
- Hypertension, β (P = 0.015)
- - 0.130
- Heart rate, β (P = 0.001)
- - 0.009
- Circumferential peak early diastolic strain rate, β (P = 0.002)
- 0.431
Original publication
Comprehensive CMR evaluation including 4D flow-derived E/A vorticity ratio in overweight adults with and without type 2 diabetes mellitus. Cardiovasc Diabetol. Published 8 December 2025. doi:10.
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