Author + information
- Mohammad Khan,
- Eric Yang,
- Mohamad Ghosn,
- Faisal Nabi,
- Stephen Pickett,
- Patrick Green,
- David Aguilar,
- William Zoghbi,
- Sherif Nagueh and
- Dipan Shah
Background: Although not fully understood, diabetes mellitus (DM) is thought to be associated with alteration of myocardial extracellular matrix (ECM). Newer cardiac magnetic resonance imaging (CMR) techniques may be able to identify this via ECV elevation. We evaluated this effect on heart failure (HF) events and all-cause mortality in diabetic patients with preserved LVEF.
Methods: Of 1,460 patients who underwent T1 mapping, 698 were eligible after exclusions (Figure). DM was verified by HbA1c >6.5%, random glucose >200 mg/dl with symptoms or hypoglycemic medication use. ECV was derived from T1 maps obtained pre and 20 minutes post gadolinium contrast using CMR, excluding segments with late gadolinium enhancement. Subsequent HF hospitalization and all-cause death were ascertained.
Results: ECV values were higher among diabetic vs. non-diabetic patients (mean 30.2% vs. 28.8%, p<0.001). Over a median follow-up of 11.9 (interquartile range 6.5 – 23.8) months, 56 deaths and 44 HF hospitalizations occurred. The group with diabetes and high ECV had worst outcomes (Figure). Significant univariate and multivariate predictors for outcomes are shown (Figure). When adjusted for these covariates, high ECV remained a predictor of events (HR 1.7 [95% Confidence Interval 1.1, 2.8], p=0.03).
Conclusions: High ECV was an independent predictor of mortality among diabetic patients and may have a synergistic effect with DM on HF outcomes. ECV may represent a novel noninvasive method to evaluate ECM alterations in DM.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Non Invasive Imaging: MR Characterization and Function
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1118-209
- 2017 American College of Cardiology Foundation