Left ventricular systolic dyssynchrony: a novel imaging marker for early assessment of myocardial damage in Chinese type 2 diabetes mellitus patients with normal left ventricular ejection fraction and normal myocardial perfusion

Yufeng Wang; Wenji Yu; Xiaoyu Yang; Feifei Zhang; Yonghong Sun; Yurui Hu; Le Yang; Qi Jiang; Jianfeng Wang; Xiaoliang Shao; Yuetao Wang

doi:10.1007/s12350-023-03215-5

Left ventricular systolic dyssynchrony: a novel imaging marker for early assessment of myocardial damage in Chinese type 2 diabetes mellitus patients with normal left ventricular ejection fraction and normal myocardial perfusion

J Nucl Cardiol. 2023 Oct;30(5):1797-1809. doi: 10.1007/s12350-023-03215-5. Epub 2023 Feb 28.

Authors

Yufeng Wang^#^{1

2}, Wenji Yu^#^{1

2}, Xiaoyu Yang³, Feifei Zhang^{4

5}, Yonghong Sun^{1

2}, Yurui Hu^{1

2}, Le Yang^{1

2}, Qi Jiang^{1

2}, Jianfeng Wang^{1

2}, Xiaoliang Shao^{1

2}, Yuetao Wang^{6

7}

Affiliations

¹ Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China.
² Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China.
³ Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China.
⁴ Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China. feifei_zhang9108@163.com.
⁵ Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China. feifei_zhang9108@163.com.
⁶ Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China. yuetao-w@163.com.
⁷ Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China. yuetao-w@163.com.

^# Contributed equally.

PMID: 36855008
DOI: 10.1007/s12350-023-03215-5

Abstract

Objectives: Myocardial damage is the important cause of heart failure (HF) in type 2 diabetes mellitus (T2DM), which is difficult to early diagnose, especially in T2DM with normal left ventricular ejection fraction (LVEF) and normal myocardial perfusion. The goal was to evaluate myocardial damage in T2DM with normal LVEF and normal myocardial perfusion by detecting left ventricular systolic dyssynchrony (LVSD), and find out the risk factors associated with LVSD.

Methods: This study included 95 T2DM with normal LVEF, normal myocardial perfusion. 69 consecutive individuals without T2DM and CAD were enrolled as the control group with age-, sex- and BMI-matched. All participants underwent stress/rest ^99mtechnetium-sestamibi (^99mTc-MIBI) gated myocardial perfusion imaging (GMPI) and two-dimensional echocardiography within 1 week. Clinical data including age, gender, BMI, duration of diabetes, chronic diabetic complications, glycated haemoglobin A1c (HbA1c), fast blood glucose (FBG) and Brain Natriuretic Peptide (BNP) were collected from medical records. Left ventricular synchrony parameters were acquired, including phase standard deviation (PSD) and phase histogram bandwidth (PBW) by rest GMPI.

Results: PSD and PBW in T2DM group were significantly higher than control group (P < .05). LVSD was detected in 20 (21%) T2DM patients. Compared to non-LVSD T2DM group, LVSD T2DM group had higher BMI, higher prevalence of BNP [Formula: see text] 35 pg/mL and chronic diabetic complications (P < .05). BNP [Formula: see text] 35 pg/mL had mild positive association with LVSD (r = 0.318, P = .004). In multivariate logistic regression, chronic diabetic complications and high BMI (> 23.4 kg/m²) were independent risk factors of LVSD (OR 5.64, 95% CI 1.58-20.16, P = .008; OR 6.77, 95% CI 1.59-28.89, P = .010).

Conclusions: LVSD existed in T2DM patients with normal LVEF and normal myocardial perfusion. Chronic diabetic complications and high BMI (> 23.4 kg/m²) were the independent risk factors of LVSD. LVSD based on GMPI can be the novel imaging marker to early assess myocardial damage in T2DM patients.

Keywords: GMPI; Type 2 diabetes mellitus; left ventricular ejection fraction; left ventricular systolic dyssynchrony.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Complications*
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / diagnostic imaging
East Asian People
Humans
Myocardial Perfusion Imaging* / methods
Stroke Volume
Ventricular Dysfunction, Left* / etiology
Ventricular Function, Left