PMID- 37381007
OWN - NLM
STAT- MEDLINE
DCOM- 20230630
LR  - 20230713
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 22
IP  - 1
DP  - 2023 Jun 28
TI  - Incremental effect of coronary obstruction on myocardial microvascular 
      dysfunction in type 2 diabetes mellitus patients evaluated by first-pass 
      perfusion CMR study.
PG  - 154
LID - 10.1186/s12933-023-01873-w [doi]
LID - 154
AB  - BACKGROUND: Type 2 diabetes mellitus (T2DM) frequently coexists with obstructive 
      coronary artery disease (OCAD), which are at increased risk for cardiovascular 
      morbidity and mortality. This study aimed to investigate the impact of coronary 
      obstruction on myocardial microcirculation function in T2DM patients, and explore 
      independent predictors of reduced coronary microvascular perfusion. METHODS: 
      Cardiac magnetic resonance (CMR) scanning was performed on 297 T2DM patients 188 
      patients without OCAD [T2DM(OCAD -)] and 109 with [T2DM(OCAD +)] and 89 control 
      subjects. CMR-derived perfusion parameters, including upslope, max signal 
      intensity (MaxSI), and time to maximum signal intensity (TTM) in global and 
      segmental (basal, mid-ventricular, and apical slices) were measured and compared 
      among observed groups. According to the median of Gensini score (64), 
      T2DM(OCAD +) patients were subdivided into two groups. Univariable and 
      multivariable linear regression analyses were performed to identify independent 
      predictors of microcirculation dysfunction. RESULTS: T2DM(OCAD -) patients, when 
      compared to control subjects, had reduced upslope and prolonged TTM in global and 
      all of three slices (all P < 0.05). T2DM(OCAD +) patients showed a significantly 
      more severe impairment of microvascular perfusion than T2DM(OCAD -) patients and 
      control subjects with a more marked decline upslope and prolongation TTM in 
      global and three slices (all P < 0.05). From control subjects, through 
      T2DM(OCAD +) patients with Gensini score </= 64, to those patients with Gensini 
      score > 64 group, the upslope declined and TTM prolonged progressively in global 
      and mid-ventricular slice (all P < 0.05). The presence of OCAD was independently 
      correlated with reduced global upslope (beta =  - 0.104, P < 0.05) and global TTM 
      (beta = 0.105, P < 0.05) in patients with T2DM. Among T2DM(OCAD +) patients, Gensini 
      score was associated with prolonged global TTM (r = 0.34, P < 0.001). 
      CONCLUSIONS: Coronary artery obstruction in the context of T2DM exacerbated 
      myocardial microcirculation damage. The presence of OCAD and Gensini score were 
      independent predictors of decreased microvascular function. TRIAL REGISTRATION: 
      Retrospectively registered.
CI  - (c) 2023. The Author(s).
FAU - Wang, Jin
AU  - Wang J
AD  - Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue 
      Xiang, Chengdu, 610041, Sichuan, China.
FAU - Yang, Zhi-Gang
AU  - Yang ZG
AD  - Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue 
      Xiang, Chengdu, 610041, Sichuan, China.
FAU - Guo, Ying-Kun
AU  - Guo YK
AD  - Department of Radiology, Key Laboratory of Obstetric and Gynecologic and 
      Pediatric Diseases and Birth Defects of Ministry of Education, West China Second 
      University Hospital, Sichuan University, 20# Section 3, Renmin South Road, 
      Chengdu, 610041, Sichuan, China.
FAU - Jiang, Yu
AU  - Jiang Y
AD  - Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue 
      Xiang, Chengdu, 610041, Sichuan, China.
FAU - Yan, Wei-Feng
AU  - Yan WF
AD  - Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue 
      Xiang, Chengdu, 610041, Sichuan, China.
FAU - Qian, Wen-Lei
AU  - Qian WL
AD  - Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue 
      Xiang, Chengdu, 610041, Sichuan, China.
FAU - Fang, Han
AU  - Fang H
AD  - Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue 
      Xiang, Chengdu, 610041, Sichuan, China.
FAU - Min, Chen-Yan
AU  - Min CY
AD  - Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue 
      Xiang, Chengdu, 610041, Sichuan, China.
FAU - Li, Yuan
AU  - Li Y
AD  - Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue 
      Xiang, Chengdu, 610041, Sichuan, China. dr.liyuan@163.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230628
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/complications/diagnosis
MH  - Heart
MH  - Perfusion
MH  - *Coronary Occlusion
MH  - *Coronary Artery Disease/diagnostic imaging/etiology
PMC - PMC10304268
OTO - NOTNLM
OT  - First-pass perfusion
OT  - Magnetic resonance imaging
OT  - Microvascular dysfunction
OT  - Obstructive coronary artery disease
OT  - Type 2 diabetes mellitus
COIS- The authors declare that they have no competing interests.
EDAT- 2023/06/29 01:08
MHDA- 2023/06/30 06:42
PMCR- 2023/06/28
CRDT- 2023/06/28 23:37
PHST- 2023/03/18 00:00 [received]
PHST- 2023/05/30 00:00 [accepted]
PHST- 2023/06/30 06:42 [medline]
PHST- 2023/06/29 01:08 [pubmed]
PHST- 2023/06/28 23:37 [entrez]
PHST- 2023/06/28 00:00 [pmc-release]
AID - 10.1186/s12933-023-01873-w [pii]
AID - 1873 [pii]
AID - 10.1186/s12933-023-01873-w [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2023 Jun 28;22(1):154. doi: 10.1186/s12933-023-01873-w.