Τίτλος:
Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes
Mellitus
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Diabetes mellitus can independently contribute to cardiovascular disease
and represents a severe risk factor for premature development of
cardiovascular disease. A three-fold higher mortality than the general
population has been observed in type 1 diabetes mellitus whereas a two-
to four-fold increased probability to develop cardiovascular disease has
been observed in type 2 diabetes mellitus. Cardiovascular magnetic
resonance, a non-radiative modality, is superior to all other modalities
in detecting myocardial infarction. The main cardiovascular magnetic
resonance sequences used include a) balanced steady-state free
precession (bSSFP) for function evaluation; b) T2-W for oedema
detection; c) T1 W for ischemia detection during adenosine stress; and
d) late gadolinium enhanced T1-W images (LGE), evaluated 15 min after
injection of paramagnetic contrast agent gadolinium, which permit the
diagnosis of replacement fibrosis, which appears white in the middle of
suppressed, nulled myocardium. Although LGE is the technique of choice
for diagnosis of replacement fibrosis, it cannot assess diffuse
myocardial fibrosis. The application of T1 mapping (native or pre
contrast and post contrast) allows identification of diffuse myocardial
fibrosis, which is not detectable my other means. Native T1 and
Contrast-enhanced T1 mapping are involved in the extracellular volume
fraction (ECV) calculation. Recently, 1H-cardiovascular magnetic
resonance spectroscopy has been applied to calculate the amount of
myocardial triglycerides, but at the moment it is not part of the
routine assessment of diabetes mellitus. The multifaceted nature of
cardiovascular magnetic resonance has the great potential of concurrent
evaluation of function and myocardial ischemia/fibrosis in the same
examination and represents an indispensable tool for accurate diagnosis
of cardiovascular disease in diabetes mellitus.
Συγγραφείς:
Mavrogeni, Sophie I.
Bacopoulou, Flora
Markousis-Mavrogenis,
George
Giannakopoulou, Aikaterini
Kariki, Ourania
Vartela,
Vasiliki
Kolovou, Genovefa
Charmandari, Evangelia
Chrousos,
George
Περιοδικό:
FRONTIERS IN ENDOCRINOLOGY
Εκδότης:
Frontiers Media SA
Λέξεις-κλειδιά:
cardiovascular; magnetic resonance; coronary artery disease; heart
failure; myocardial fibrosis; diabetes; cardiac MRI; cardiac function
DOI:
10.3389/fendo.2021.672302
