Assessment of left-ventricular diastolic function in diabetic patients: the role of cardiac MR imaging

To evaluate the reliability of cardiac magnetic resonance (CMR) imaging in diabetic patients with clinically suspected cardiomyopathy and to compare the consistency of CMR imaging with 2-dimensional echocardiography (2DE). Materials and methods: Twenty-one diabetic patients with clinically suspected cardiomyopathy were evaluated with CMR imaging and 2DE. Two observers for each modality performed the evaluation. Quantitative data (the ejection fraction, end-systolic volume, end-diastolic volume, left-ventricular mass index, and left-atrial volume index) were acquired from both observers. The data were compared for statistical agreement using the Bland-Altman test between the modalities. Results: The CMR examination and 2DE results were consistent with each other. There was strong agreement between the 2 methods. The intraclass correlation-coefficient comparison of the data from the 2 observers of each modality showed that the CMR observers' measurements were more consistent than the 2DE observers' measurements. Conclusion: This study demonstrates that compared with CMR, 2DE has much poorer reproducibility and much higher interobserver variability. Although 2DE is currently the noninvasive imaging technique used to assess diastolic function in diabetic patients, CMR imaging is emerging as a valuable alternative, having the unique potential of function analysis.

Assessment of left-ventricular diastolic function in diabetic patients: the role of cardiac MR imaging

To evaluate the reliability of cardiac magnetic resonance (CMR) imaging in diabetic patients with clinically suspected cardiomyopathy and to compare the consistency of CMR imaging with 2-dimensional echocardiography (2DE). Materials and methods: Twenty-one diabetic patients with clinically suspected cardiomyopathy were evaluated with CMR imaging and 2DE. Two observers for each modality performed the evaluation. Quantitative data (the ejection fraction, end-systolic volume, end-diastolic volume, left-ventricular mass index, and left-atrial volume index) were acquired from both observers. The data were compared for statistical agreement using the Bland-Altman test between the modalities. Results: The CMR examination and 2DE results were consistent with each other. There was strong agreement between the 2 methods. The intraclass correlation-coefficient comparison of the data from the 2 observers of each modality showed that the CMR observers' measurements were more consistent than the 2DE observers' measurements. Conclusion: This study demonstrates that compared with CMR, 2DE has much poorer reproducibility and much higher interobserver variability. Although 2DE is currently the noninvasive imaging technique used to assess diastolic function in diabetic patients, CMR imaging is emerging as a valuable alternative, having the unique potential of function analysis.

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  • Hayat SA, Patel B, Khattar RS, Malik RA. Diabetic cardiomyopathy: mechanisms, diagnosis and treatment. Clin Sci 2004; 107: 539–57.
  • Karamitsos TD, Karvounis HI, Dalamanga EG, Papadopoulos CE, Didangellos TP, Karamitsos DT et al. Early diastolic impairment of diabetic heart: the significance of right ventricle. Int J Cardiol 2007; 114: 218–23.
  • Schiller NB, Botvinick EH. Noninvasive quantitation of the left heart by echocardiography and scintigraphy. Cardiovasc Clin 1986; 17: 45–93.
  • Hayley BD, Burwash IG. Heart failure with normal left ventricular ejection fraction: role of echocardiography. Curr Opin Cardiol 2012; 27: 169–80.
  • Asghar O, Al-Sunni A, Khavandi K, Khavandi A, Withers S, Greenstein A et al. Diabetic cardiomyopathy. Clin Sci 2009; 116: 741–60.
  • Mirsky I. Assessment of diastolic function: suggested methods and future considerations. Circulation 1984; 69: 836–41.
  • Yalçın F, Thomas J. Diastolic dysfunction: pathogenesis, therapy and the importance of Doppler echocardiography. Turk J Med Sci 1999; 29: 501–6.
  • Zile MR, Gaasch WH, Carroll JD, Feldman MD, Aurigemma GP, Schaer GL et al. Heart failure with a normal ejection fraction: is measurement of diastolic function necessary to make the diagnosis of diastolic heart failure? Circulation 2001; 104: 779–82.
  • Galderisi M. Diastolic dysfunction and diabetic cardiomyopathy: evaluation by Doppler echocardiography. J Am Coll Cardiol 2006; 48: 1548–51.
  • Aksakal E, Sevimli S, Gürlertop HY, Elbey MA, Taş MH, Gündoğdu F et al. Assessment of the left atrial longitudinal myocardial function by the strain and strain rate echocardiography in patients with rheumatic mitral stenosis. Turk J Med Sci 2011; 41: 965–74.
  • Daneshvar D, Wei J, Tolstrup K, Thomson LE, Shufelt C, Merz CN. Diastolic dysfunction: improved understanding using emerging imaging techniques. Am Heart J 2010; 160: 394–404.
  • Walsh TF, Hundley WG. Assessment of ventricular function with cardiovascular magnetic resonance. Cardiol Clin 2007; 25: 15–33.
  • Selvanayagam J, Westaby S, Channon K, Francis J, Eichhõfer J, Saito S et al. Images in cardiovascular medicine. Surgical left ventricular restoration: an extreme case. Circulation 2003; 107: e
  • Hazirolan T, Tasbas B, Dagoglu MG, Canyigit M, Abali G, Aytemir K et al. Comparison of short and long axis methods in cardiac MR imaging and echocardiography for left ventricular function. Diagn Interv Radiol 2007; 13: 33–8.
  • Di Bonito P, Moio N, Cavuto L, Covino G, Murena E, Scilla C et al. Early detection of diabetic cardiomyopathy: usefulness of tissue Doppler imaging. Diabet Med 2005; 22: 1720–5.
  • Kahn JK, Zola B, Juni JE, Vinik AI. Radionuclide assessment of left ventricular diastolic filling in diabetes mellitus with and without cardiac autonomic neuropathy. J Am Coll Cardiol 1986; 7: 1303–9.
  • From AM, Scott CG, Chen HH. The development of heart failure in patients with diabetes mellitus and pre-clinical diastolic dysfunction. A population-based study. J Am Coll Cardiol 2010; 55: 300–5.
  • Rijzewijk LJ, van der Meer RW, Lamb HJ, de Jong HW, Lubberink M, Romijn JA et al. Altered myocardial substrate metabolism and decreased diastolic function in nonischemic human diabetic cardiomyopathy: studies with cardiac positron emission tomography and magnetic resonance imaging. J Am Coll Cardiol 2009; 54: 1524–32.
  • Krishnamurthy R, Pednekar A, Cheong B, Muthupillai R. High temporal resolution SSFP cine MRI for estimation of left ventricular diastolic parameters. J Magn Reson Imaging 2010; 31: 872–80.
  • Steen H, Nasir K, Flynn E, El-Shehaby I, Lai S, Katus HA et al. Is magnetic resonance imaging the ‘reference standard’ for cardiac functional assessment? Factors influencing measurement of left ventricular mass and volumes. Clin Res Cardiol 2007; 96: 743–51.
  • Bollache E, Redheuil A, Clément-Guinaudeau S, Defrance C, Perdrix L, Ladouceur M et al. Automated left ventricular diastolic function evaluation from phase-contrast cardiovascular magnetic resonance and comparison with Doppler echocardiography. J Cardiovasc Magn Reson 2010; 12:
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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