Abstract 15128: Myocardial Blood Flow in Angiographically Normal Patients with Type 2 Diabetes Mellitus, Prediabetes and Normal Controls - A Cardiovascular Magnetic Resonance Perfusion Study
Introduction Type 2 Diabetes Mellitus (T2DM) and prediabetes are associated with an increased cardiovascular risk and heart failure independent of the presence of obstructive coronary artery disease, caused in part by myocardial microvascular dysfunction.
Hypotheses We hypothesised that myocardial blood flow (MBF) reserve measured by cardiovascular magnetic resonance (CMR) is impaired in patients with T2DM and also in patients with prediabetes. Making use of the high resolution of CMR, we also sought to assess the MBF separately in the endocardial and epicardial layers.
Methods Fifty patients with no coronary stenosis >30% on invasive angiography were recruited and categorized into T2DM, prediabetes and normal controls groups according to American Diabetes Association guidelines. All patients underwent adenosine stress and rest myocardial perfusion CMR. Rest and stress MBF and MBF reserve were calculated using Fermi-constrained deconvolution for the entire myocardium and the endocardial and epicardial layers.
Results Patient characteristics and results are shown in table 1. Patients with T2DM had significantly higher resting MBF in the entire myocardium and both myocardial layers than the two other groups. MBF reserve however was significantly lower in T2DM patients compared to patients with prediabetes and normal controls (Figure 1). Patients with prediabetes had lower MBF reserve than normal controls (not statistically significant).
Conclusion T2DM patients when compared to age-matched patients with prediabetes and normal controls have higher resting transmural MBF but a lower MBF reserve. The endocardial and epicardial layers are equally affected.
- © 2011 by American Heart Association, Inc.