Right ventricular function and dimensions in type 2 diabetes mellitus
Journal of Cardiovascular Magnetic Resonance volume 14, Article number: P71 (2012)
Right ventricular (RV) function has proven to be of importance for patient risk stratification in heart failure and is associated with sudden death and exercise limitation. RV dysfunction might play an important role in diabetic cardiomyopathy. We therefore assessed RV function and volumes using MRI in patients with otherwise uncomplicated type 2 diabetes mellitus (T2DM), and compared RV parameters with those of the left ventricle (LV).
Steady-state free precession sequences were used to assess RV dimensions in 78 uncomplicated T2DM patients and 28 healthy subjects within the same range of age. Furthermore, flow velocity mappings across the pulmonary valve and tricuspid valve were used to assess RV outflow and diastolic filling patterns respectively.
RV end-diastolic volume was significantly decreased in patients compared to healthy subjects, also after adjustment for BMI and pulse pressure (177 ± 28 ml vs. 197 ± 47 ml, P<0.01). RV systolic function was impaired: Peak ejection rate across the pulmonary valve was significantly lower (433 ± 54 vs. 463 ± 71 mL/s, P<0.01). Indexes of RV diastolic function were impaired: E peak filling rate and E deceleration peak were 315 ± 63 ml/s vs. 356 ± 90 ml/s, P<0.01 and 2.3 ± 0.8 ml/s2 * 10-3 vs. 2.8 ± 0.8 mL/s2 * 10-3, P<0.01, respectively. All RV parameters strongly correlated with its corresponding LV parameter (P<0.001).
Diabetic cardiomyopathy affects the right ventricle, similar to changes in LV dimensions and function. These observations suggest that right ventricular impairment is a component of the diabetic cardiomyopathy phenotype.
This research was performed within the framework of the Center for Translational Molecular Medicine (www.ctmm.nl), project PREDICCt (grant 01C-104), and supported by the Netherlands Heart Foundation, the Dutch Diabetes Research Foundation, the Dutch Kidney Foundation, and Eli Lilly, the Netherlands.
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Widya, R., Van Der Meer, R., Smit, J.W. et al. Right ventricular function and dimensions in type 2 diabetes mellitus. J Cardiovasc Magn Reson 14 (Suppl 1), P71 (2012). https://doi.org/10.1186/1532-429X-14-S1-P71