Abstract 12293: Plaque Vulnerability of Coronary Artery Lesions is Related to Left Ventricular Dilatation as Determined by Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging in Patients With Type 2 Diabetes
Background: Patients with type 2 diabetes are at increased risk for both, left ventricular (LV)-dilatation and myocardial infarction (MI) following the rupture of a vulnerable plaque. This study investigated the to date incompletely understood relationship between plaque vulnerability and LV-dilatation using optical coherence tomography (OCT) and cardiac magnetic resonance imaging (CMR) in patients with type 2 diabetes and stable coronary artery disease.
Methods: CMR was performed in 49 patients with type 2 diabetes, in which 72 coronary lesions were investigated using OCT.
Results: A decreased minimal fibrous cap thickness (FCT) of coronary lesions was associated with an increase of several CMR-derived parameters including LV-end diastolic volume (LVEDV, r=0.506, p≤0.001), LV-end diastolic diameter (r=0.488, p≤0.002) and LV-end systolic volume (r=0.445, p≤0.005). Similar results were obtained for mean FCT.
Furthermore, patients with dilated versus non-dilated LV differed significantly in several cardiovascular risk factors including previous MI (65.4% vs. 26%, p≤0.001), HDL-cholesterol (38.50±5.56mg/dl vs. 46.91±10.11mg/dl, p≤0.001) and male gender (100.0% vs. 63.6%, p≤0.006). However, minimal FCT is associated to LV-dilatation independent of previous MIs (odds ratio 0.642, p=0.018).
Receiver-operating curve analysis demonstrated that CMR-derived LVEDV predicts plaque vulnerability with low diagnostic efficiency (area under the curve 0.686) but considerate specificity (84.2%) at the optimal cut-off value (161.5ml).
Conclusion: These data suggest that vulnerability of coronary lesions is associated with LV-dilatation in high risk patients with type 2 diabetes. CMR may be a useful adjunct to the risk-stratification in this population. Future studies are warranted to investigate potential mechanisms linking plaque vulnerability and LV-dilatation.
- © 2013 by American Heart Association, Inc.