Rapid Fire Abstracts
Sungho Park, PhD
Postdoctoral Fellow
Children's Hospital Colorado, University of Colorado Anschutz Medical Campus
Sungho Park, PhD
Postdoctoral Fellow
Children's Hospital Colorado, University of Colorado Anschutz Medical Campus
Erin Englund, PhD
Assistant Research Professor
University of Colorado Anschutz Medical Campus
Takashi Fujiwara, PhD
Postdoctoral fellow
University of Colorado Anschutz Medical Campus, Children's Hospital Colorado
Danny Enge, MSc
Researcher
University of Colorado Anschutz Medical Campus
Michal Schafer, MD
Intern
University of Utah Health
Judith G. Regensteiner, PhD
University of Colorado
Brian Fonseca, MD
Associate Professor of Pediatrics
Children's Hospital Colorado
Kendall Hunter, PhD
University of Colorado Denver | Anschutz Medical Campus
Jane Reusch, MD
University of Colorado
Alex J. Barker, PhD
Associate Professor
Children's Hospital Colorado, University of Colorado Anschutz Medical Campus
Type 2 diabetes (T2D) is closely associated with left ventricular (LV) diastolic dysfunction. However, given the limited understanding of T2D pathways, it remains unclear if diastolic function differs between overweight individuals with uncomplicated T2D and overweight controls (OWC). Recently, four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) has been proven to perform similarly to the gold standard, Doppler echocardiography, in assessing E/A ratio.1 In this study, we compare LV diastolic function among lean controls (LC), OWC, and T2D using CMR techniques.
Methods:
54 participants were prospectively recruited with IRB approval and informed consent, including 8 LC, 27 OWC, and 19 T2D. OWC had no history of cardiovascular disease, obesity, or diabetes. T2D participants were well-managed by diet, with or without insulin secretagogues, metformin, or glucose absorption blockers; other antihyperglycemic therapies were excluded to avoid potential impacts on cardiovascular function. CMR images were acquired using a 3T Siemens Skyra MRI system (Siemens Healthineers). 4D flow-based mitral valve (MV) tracking was performed using a commercial software, CVI42 (Circle Cardiovascular Imaging Inc.) (Fig. 1). Volumetric-averaged vorticity, a sensitive marker of diastolic dysfunction,2 was assessed using MATLAB (MathWorks Inc.) and FSL flirt.3 E/A velocity and vorticity were computed for each group. Global functions and strain changes were obtained using short-axis and 4-chamber cine images. Statistical significance was assessed using ANOVA with Fisher’s Least Significant Difference post-hoc test.
Results:
Demographic and CMR data are summarized in Table 1. Participants with T2D had significantly lower end-systole volume index (ESVi; p< 0.05), end-diastole volume index (EDVi; p< 0.01), and stroke volume (SV; p< 0.01) compared to OWC. While only global longitudinal strain showed significant decreases compared to LC, no significant differences were observed in other CMR variables. A-wave velocity and E/A vorticity were significantly different across all groups (Fig. 2).
Conclusion:
We demonstrated that CMR variables can identify morphological changes concomitant with LV diastolic dysfunction in uncomplicated T2D. Increased A-wave velocity and decreased E/A vorticity may be associated with an impaired relaxation pattern.4 Since the use of CMR for assessing LV function has not been well established, this study would support its potential for the comprehensive evaluation of LV function in both OWC and T2D populations. Semi-automatic analysis of volumetric vorticity may reduce the time-consuming post-processing required to evaluate LV function. In addition, the use of widely available commercial software for this approach enhances accessibility and broadens its applicability. Further validation will be conducted using robust methods, such as Tukey’s post hoc test, with larger datasets.
