Non-invasive quantification of myocardial fibrosis in diabetic cardiomyopathy: T1 mapping or integrated backscatter?

Jellis, C., Wright, J., Sacre, J., Kennedy, D., Haluska, B., Jenkins, C., Martin, J. and Marwick, T. H. (2010). Non-invasive quantification of myocardial fibrosis in diabetic cardiomyopathy: T1 mapping or integrated backscatter?. In: European Society of Cardiology Congress 2010, Copenhagan, Denmark, (295-295). 28 August - 1 September 2010.

Author Jellis, C.
Wright, J.
Sacre, J.
Kennedy, D.
Haluska, B.
Jenkins, C.
Martin, J.
Marwick, T. H.
Title of paper Non-invasive quantification of myocardial fibrosis in diabetic cardiomyopathy: T1 mapping or integrated backscatter?
Conference name European Society of Cardiology Congress 2010
Conference location Copenhagan, Denmark
Conference dates 28 August - 1 September 2010
Journal name European Heart Journal   Check publisher's open access policy
Place of Publication Oxford, United Kingdom
Publisher Oxford University Press
Publication Year 2010
Sub-type Published abstract
ISSN 1522-9645
Volume 31
Issue Suppl. 1
Start page 295
End page 295
Total pages 1
Language eng
Formatted Abstract/Summary
Purpose: Interstitial fibrosis is believed to be one of several contributors to diabetic
cardiomyopathy (DCM), manifesting as myocardial dysfunction in the absence
of ischemic heart disease in subjects with type 2 diabetes (T2DM). Myocardial
ultrasound reflectivity is proportionate to fibrosis, but use of the pericardium
as a frame of reference (calibrated integrated backscatter, cIB) may be limited
by signal saturation. Recently, diffuse fibrosis has been shown to be inversely
proportionate to T1 time on post-contrast T1 mapping using cardiac magnetic
resonance imaging. We sought to compare the association of cIB and T1 time
with DCM.
Demographic, anthropometric, hemodynamic and biochemical data
were measured in 107 apparently healthy, asymptomatic subjects with T2DM (65
men, 60±9 years). LV dysfunction (LVD) was sought on resting echo (early diastolic
tissue velocity [Em] < 1SD from mean for age). Ischemia was excluded
by exercise echo. Standard 2D and color TDI measures (tissue velocity, strain
and strain rate) were acquired in apical long axis views. Calibrated integrated
backscatter (cIB) was calculated from a parasternal long axis view. Tonometric
aortic pulse wave velocity (APWV) was used to determine arterial stiffness. T1
mapping was performed in those with LVD and matched controls.
LVD was identified in 23 subjects (28%) who also demonstrated significantly
poorer diabetic control (HbA1c 8.2±2.0 vs 7.3±1.4 mmol/L) but no relationship
with cIB. T1 mapping was performed in 26 subjects (17 men, 60±10
years) comprising 20 with LVD and 6 controls. Em was independently associated
with age (β=-0.76 p<0.001), body mass index [BMI] (β=-0.65, p<0.001), strain
(β=0.51, p=0.003) and post-contrast T1 time (β=0.36, p=0.04) [model R Square =
0.63] but not cIB. Post-contrast T1 time was independently associated with insulin
resistance (HOMA-IR β=-0.63, p=0.016) [model R Square = 0.38] but not with
cIB, APWV, BMI or low density lipoprotein (LDL). The only independent correlate
of cIB was APWV (β=0.59, p=0.009) [model R Square = 0.39] and not HOMA-IR,
Conclusions: Quantitative tissue characterisation of fibrosis (T1 time) was independently
associated with subclinical DCM, in addition to systolic dysfunction
(strain), age and BMI. The association of T1 mapping with insulin resistance contrasts
with the link between cIB and arterial stiffness, suggesting potential differences
between fibrosis in DCM and hypertension.
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes P1721

Document type: Conference Paper
Collection: School of Medicine Publications
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Created: Tue, 07 Jun 2011, 15:40:10 EST by Dr Jennifer Martin on behalf of Mater Clinical School