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Increased fractal dimension of left ventricular trabeculations is associated with subclinical diastolic dysfunction in patients with type-2 diabetes mellitus.
Int J Cardiovasc Imaging. 2019 Apr; 35(4):665-673.IJ

Abstract

The aim of this study was to investigate the relationship among left ventricular (LV) concentric hypertrophy, endocardial remodeling, and myocardial deformation in type-2 diabetes mellitus (T2DM). Fifty-three T2DM patients with normotension and 36 healthy controls underwent cardiovascular magnetic resonance imaging to assess for LV concentric hypertrophy (LV myocardial mass index, LVMMi; LVMMi-to-LV end-diastolic volume index ratio, MVR), endocardial remodeling (fractal dimension of trabeculations, FD), and myocardial deformation (global longitudinal, radial and circumferential strain, systolic and diastolic strain rate). When compared with healthy controls, T2DM was associated with LV concentric hypertrophy (LVMMi: T2DM, 52.7 ± 8.9 g/m2; controls, 48.7 ± 8.4 g/m2, p = 0.032; MVR: T2DM, 0.88 ± 0.19 g/mL; controls, 0.77 ± 0.16 g/mL, p = 0.007), endocardial remodeling (max. apical FD: T2DM, 1.265 ± 0.056; controls, 1.233 ± 0.055, p = 0.008; mean apical FD: T2DM, 1.198 ± 0.043; controls, 1.176 ± 0.043, p = 0.020), and subtle diastolic dysfunction (peak longitudinal diastolic strain rate, PDSRL: T2DM, 1.1 ± 0.2/s; controls, 1.2 ± 0.3/s, p = 0.031). In the stepwise multivariable regression model, the MVR was an independent determinant of the maximum apical FD (standardized β, sβ = 0.525, p < 0.001) and mean apical FD (sβ = 0.568, p < 0.001). The mean apical FD was an independent determinant of the PDSRL (p = 0.004). LV concentric hypertrophy is an independent determinant of endocardial remodeling, a process that may contribute to subtle LV diastolic dysfunction in T2DM patients.

Authors+Show Affiliations

Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China.Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China. zxcylxyr@163.com.Department of Endocrinology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China.Department of Endocrinology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China.Department of Endocrinology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China.MR Collaboration, Siemens Healthcare Ltd., Shanghai, China.Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, USA.Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China.Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China.Department of Endocrinology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China. ziwenliang99@163.com.Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street No. 30, Shapingba District, Chongqing, China. wangjian_811@yahoo.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30430327

Citation

Shang, Yongning, et al. "Increased Fractal Dimension of Left Ventricular Trabeculations Is Associated With Subclinical Diastolic Dysfunction in Patients With Type-2 Diabetes Mellitus." The International Journal of Cardiovascular Imaging, vol. 35, no. 4, 2019, pp. 665-673.
Shang Y, Zhang X, Leng W, et al. Increased fractal dimension of left ventricular trabeculations is associated with subclinical diastolic dysfunction in patients with type-2 diabetes mellitus. Int J Cardiovasc Imaging. 2019;35(4):665-673.
Shang, Y., Zhang, X., Leng, W., Lei, X., Chen, L., Zhou, X., Chow, K., Shi, Y., Dong, J., Liang, Z., & Wang, J. (2019). Increased fractal dimension of left ventricular trabeculations is associated with subclinical diastolic dysfunction in patients with type-2 diabetes mellitus. The International Journal of Cardiovascular Imaging, 35(4), 665-673. https://doi.org/10.1007/s10554-018-1492-0
Shang Y, et al. Increased Fractal Dimension of Left Ventricular Trabeculations Is Associated With Subclinical Diastolic Dysfunction in Patients With Type-2 Diabetes Mellitus. Int J Cardiovasc Imaging. 2019;35(4):665-673. PubMed PMID: 30430327.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased fractal dimension of left ventricular trabeculations is associated with subclinical diastolic dysfunction in patients with type-2 diabetes mellitus. AU - Shang,Yongning, AU - Zhang,Xiaochun, AU - Leng,Weiling, AU - Lei,Xiaotian, AU - Chen,Liu, AU - Zhou,Xiaoyue, AU - Chow,Kelvin, AU - Shi,Yanshu, AU - Dong,Jianlong, AU - Liang,Ziwen, AU - Wang,Jian, Y1 - 2018/11/14/ PY - 2018/07/09/received PY - 2018/10/31/accepted PY - 2018/11/16/pubmed PY - 2019/5/7/medline PY - 2018/11/16/entrez KW - Concentric hypertrophy KW - Endocardial remodeling KW - Fractal dimension of trabeculations KW - Myocardial deformation KW - Type-2 diabetes mellitus SP - 665 EP - 673 JF - The international journal of cardiovascular imaging JO - Int J Cardiovasc Imaging VL - 35 IS - 4 N2 - The aim of this study was to investigate the relationship among left ventricular (LV) concentric hypertrophy, endocardial remodeling, and myocardial deformation in type-2 diabetes mellitus (T2DM). Fifty-three T2DM patients with normotension and 36 healthy controls underwent cardiovascular magnetic resonance imaging to assess for LV concentric hypertrophy (LV myocardial mass index, LVMMi; LVMMi-to-LV end-diastolic volume index ratio, MVR), endocardial remodeling (fractal dimension of trabeculations, FD), and myocardial deformation (global longitudinal, radial and circumferential strain, systolic and diastolic strain rate). When compared with healthy controls, T2DM was associated with LV concentric hypertrophy (LVMMi: T2DM, 52.7 ± 8.9 g/m2; controls, 48.7 ± 8.4 g/m2, p = 0.032; MVR: T2DM, 0.88 ± 0.19 g/mL; controls, 0.77 ± 0.16 g/mL, p = 0.007), endocardial remodeling (max. apical FD: T2DM, 1.265 ± 0.056; controls, 1.233 ± 0.055, p = 0.008; mean apical FD: T2DM, 1.198 ± 0.043; controls, 1.176 ± 0.043, p = 0.020), and subtle diastolic dysfunction (peak longitudinal diastolic strain rate, PDSRL: T2DM, 1.1 ± 0.2/s; controls, 1.2 ± 0.3/s, p = 0.031). In the stepwise multivariable regression model, the MVR was an independent determinant of the maximum apical FD (standardized β, sβ = 0.525, p < 0.001) and mean apical FD (sβ = 0.568, p < 0.001). The mean apical FD was an independent determinant of the PDSRL (p = 0.004). LV concentric hypertrophy is an independent determinant of endocardial remodeling, a process that may contribute to subtle LV diastolic dysfunction in T2DM patients. SN - 1875-8312 UR - https://www.unboundmedicine.com/medline/citation/30430327/Increased_fractal_dimension_of_left_ventricular_trabeculations_is_associated_with_subclinical_diastolic_dysfunction_in_patients_with_type_2_diabetes_mellitus_ L2 - https://doi.org/10.1007/s10554-018-1492-0 DB - PRIME DP - Unbound Medicine ER -