Abstract 3215: Left Ventricular Strain is Reduced in Remote Non-Diseased Myocardial Segments Following Myocardial Infarction in Patients With Type-2 Diabetes Mellitus
Background: Type-II diabetes mellitus (DM) is a strong risk factor for adverse left ventricular (LV) remodeling and heart failure (HF) following myocardial infarction (MI). Alteration of LV strain following MI occurs in both diseased and remote non-diseased myocardial segments and is associated with adverse LV remodeling. In the current study we use tissue-tagged magnetic resonance imaging (MRI) to evaluate differences in LV strains in diseased and remote non-diseased segments in post-MI patients with and without DM that may potentially underlie the increased propensity of post-MI DM patients to develop HF.
Methods: Twenty-seven DM and 32 non-DM patients underwent cardiac-MRI within one week of MI. Three dimensional circumferential and longitudinal LV strains were calculated and averaged for each patient over diseased (distal to >55% vessel stenosis) and remote non-diseased LV segments.
Results: There were no significant differences in age, blood pressures, heart rate, LV ejection fraction (54.0±1.7 vs. 58.2±1.5%), radius to wall thickness ratio (3.4±0.1 vs. 3.3±0.2), or number of diseased cardiac segments per patient (6.5±0.8 vs. 5.9±0.6) between DM and non-DM groups, respectively (p>0.05 in all cases). In both groups, circumferential strain was decreased in diseased versus remote non-diseased segments. There were no significant differences in the strains of diseased areas in DM and non-DM groups. DM patients however, demonstrated significantly reduced circumferential strain in non-diseased areas compared to non-diseased areas in non-DM patients (See table⇓).
Conclusions: When compared to non-DM patients, DM patients demonstrated significantly reduced circumferential strain in remote non-diseased myocardial segments post-MI. Reduced strains in remote non-diseased myocardium may contribute to the increased incidence of adverse remodeling and heart failure in post-MI DM patients.