Evaluation of left ventricular systolic and diastolic function in subjects with prediabetes and diabetes using cardiovascular magnetic resonance-feature tracking

Aims: The aim of this study was to evaluate alterations in left ventricular (LV) systolic and diastolic function in subjects with prediabetes and diabetes using cardiovascular magnetic resonance-feature tracking (CMR- FT).

Methods: We included 35 subjects with prediabetes, 30 subjects with diabetes, and 33 healthy controls of similar age and sex distributions who underwent CMR examination. LV global radial, circumferential, and longitudinal strain (GRS, GCS, and GLS), peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR) were measured and compared among the three groups. Pearson's correlation and linear regression analyses were applied for statistical analyses.

Results: Subjects with prediabetes and diabetes had a significantly lower GLS than healthy controls, but there were no significant differences in ejection fraction (EF), GRS, GCS, or global radial, circumferential and longitudinal PSSR among the three groups. Global radial, circumferential, and longitudinal PDSR in patients with diabetes were all significantly lower than those in the healthy controls. Compared to subjects with prediabetes, patients with diabetes had a significantly lower global circumferential PDSR. Global longitudinal PDSR in subjects with prediabetes was significantly lower than that in healthy controls. Multivariable linear regression analyses demonstrated that elevated HbA1c levels were independently associated with decreased global circumferential and longitudinal PDSR (β = -0.203, p = 0.023; β = -0.207, p = 0.040, respectively).

Conclusions: CMR-FT has potential value to evaluate early alterations in LV systolic and diastolic function in subjects with prediabetes and diabetes. Elevated HbA1c levels were independently associated with impaired LV diastolic function in the general population free of overt cardiovascular diseases.