心脏磁共振评估2型糖尿病患者左心室整体功能及其与临床指标相关性研究

Evaluation of left ventricular global function in patients with type diabetes mellitus by cardiac magnetic resonance imaging and correlation with clinical parameters

关键词:  心脏磁共振成像  2型糖尿病  左心室整体功能

Key words:  cardiac magnetic resonance  type diabetes mellitus  left ventricular global function

摘要:

目的　探讨心脏磁共振（CMR）对2型糖尿病患者左心室整体功能评价的临床应用价值。方法　应用心脏磁共振真实稳定进动序列（True SSFP）对3例2型糖尿病患者进行扫描，并通过磁共振电影技术获得心脏位置、形态及瓣膜运动等情况，同时选取25例健康志愿者作对照。采用Argus心功能处理软件自动描绘左室从心底至心尖范围的心肌内、外膜轮廓，并对其进行测量及运算得出左室整体收缩及舒张功能指标。随后观察其与心率、收缩压、舒张压、HBA1C、BMI之间的相关性。结果　舒张末期质量指数（EDMI)糖尿病组(28.10±172）kg/m小于对照组（364±101）kg/m，差异有显著性意义(P<0.01）；高峰充盈率(PFR)糖尿病组（2855±635）小于对照组（349.79±692），差异有显著性意义(P<0.01）；高峰充盈时间（TPFR）糖尿病组 （227.42±1080）ms大于对照组（159.21±27.36）ms，差异有显著性意义(P<0.05）。相关性分析显示：PFR与体重指数(BMI)呈负相关(r=-0.695，P=0.026）；PFR与糖化血红蛋白（HBA1C）呈负相关(r=-0.528，P=0.006）；PFR与低密度脂蛋白(LDL)呈负相关(r=-0.755，P=0.007）。结论　CMR能够准确评价2型糖尿病患者的左心室整体功能改变情况，主要表现为舒张功能障碍早于收缩功能障碍，且BMI、HBA1C及LDL增高均可影响2型糖尿病患者左心室舒张功能。

Abstract:

Objective To evaluate left ventricular global function in patients with type diabetes by cardiac magnetic resonance imaging(CMR) and analyze its correlation with clinical indicators.Methods Cardiac magnetic resonance imaging true and steady-state free-precession (true SSFP) was performed on3 cases of type diabetic patients (10 males，13 females，mean age (578±9.64) years，mean duration (136±7.24) years，according with American Diabetes Association and the American Diabetes Association (2007，ADA) of type diabetes diagnostic criteria) and5 cases of normal volunteers (13 males，12 females).The average age was (563±48) years.Cine magnetic resonance technique was used to obtain heart position，valve movement and so on.After the scan，the Argus software was used to automatic described the left ventricular endocardium and epicardium，and the left ventricular systolic function and diastolic function were measured.The correlation of heart rate，systolic blood pressure，diastolic blood pressure，BMI and HBA1C was analyzed in the patients with diabetes mellitus.SPSS9.0 analysis software was used for statistical analysis，the difference was statistically significant with P< 0.0Results End diastolic mass index (EDMI) in diabetes group (28.10±172)kg/m，was significantly different from normal control group(364±101)kg/m，P<0.01; peak filling time(PFR) in diabetes group (2855±635)mL/s,was significantly different from normal control group(349.79±692)mL/s，P<0.01; time of peak filling time (TPFR) in diabetes group (227.42±1080)ms，was significantly different from normal control group(159.21±27.36)ms，P<0.0Correlation analysis revealed PFR was negatively correlated with BMI(r=-0.695，P=0.026)，PFR was negatively correlated with HBA1C(r=-0.528，P=0.006)，and PFR was negatively correlated with LDL(r=-0.755,P=0.007).Conclusion CMR technique can accurately evaluate the left ventricular global function in patients with type diabetes mellitus.The changes of left cardiac function in type diabetes mellitus patients were mainly caused by the dysfunction of diastolic dysfunction.BMI，HBA1C and LDL increased can all influence cardiac diastolic function in type diabetes mellitus patients.