The combined effects of cardiac geometry, microcirculation, and tissue characteristics on cardiac systolic and diastolic function in subclinical diabetes mellitus-related cardiomyopathy.

Diabetes mellitus-related cardiomyopathy has recently been described as a distinct progression of left ventricular (LV) systolic and diastolic dysfunction. Pathological changes in the myocardium may explain the development of two different phenotypes. We evaluated the effects of LV geometry, myocardial microcirculation, and tissue characteristics on cardiac deformation in patients with subclinical type 2 diabetes mellitus (T2DM) utilizing multiparametric cardiac magnetic resonance (CMR) imaging. A total of 135 T2DM patients and 55 matched controls were prospectively enrolled and performed multiparametric CMR examination. CMR-derived parameters including cardiac geometry, function, microvascular perfusion, T1 mapping, T2 mapping, and strain were analyzed and compared between T2DM patients and controls. The univariable and multivariable analysis of systolic and diastolic function revealed that longer duration of diabetes was associated with decreased longitudinal peak systolic strain rate (PSSR-L) (β = 0.195, p =.013), and higher remodeling index and higher extracellular volume (ECV) tended to correlate with decreased longitudinal peak diastolic strain rate (PDSR-L) (remodeling index, β = −0.339, p =.000; ECV, β = −0.172, p =.026), whereas microvascular perfusion index and T2 value affected both PSSR-L (perfusion index, β = −0.328, p =.000; T2 value, β = 0.306, p =.000) and PDSR-L (perfusion index, β = 0.209, p =.004; T2 value, β = −0.275, p =.000) simultaneously. The LV concentric remodeling and myocardial fibrosis correlated with diastolic function, and perfusion function and myocardial edema were associated with both LV systolic and diastolic function. • Diabetes causes disturbance in cardiac structure, perfusion, tissue and function. • Cardiac subunits presented diverse effects on systolic and diastolic function. • Left ventricular concentric remodeling and fibrosis affect diastolic function. • Myocardial perfusion and edema corresponded with systolic and diastolic function. • The duration of diabetes affects systolic function by acting on certain mechanisms. [ABSTRACT FROM AUTHOR]