Cohort comparison study of cardiac disease and atherosclerotic burden in type 2 diabetic adults using whole body cardiovascular magnetic resonance imaging

Suzanne L. Duce, Jonathan R. Weir-McCall (Lead / Corresponding author), Stephen J. Gandy, Shona Z. Matthew, Deirdre B. Cassidy, Lynne McCormick, Petra Rauchhaus, Helen Looker, Helen M. Colhoun, J. Graeme Houston

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Abstract

Background: Whole body cardiovascular MR (WB CVMR) combines whole body angiography and cardiac MR assessment. It is accepted that there is a high disease burden in patients with diabetes, however the quantification of the whole body atheroma burden in both arterial and cardiac disease has not been previously reported. In this study we compare the quantified atheroma burden in those individuals with and without diabetes by clinical cardiovascular disease (CVD) status. Methods: 158 participants underwent WB CVMR, and were categorised into one of four groups: (1) type 2 diabetes mellitus (T2DM) with CVD; (2) T2DM without CVD; (3) CVD without T2DM; (4) healthy controls. The arterial tree was subdivided into 31 segments and each scored according to the degree of stenosis. From this a standardised atheroma score (SAS) was calculated. Cardiac MR and late gadolinium enhancement images of the left ventricle were obtained for assessment of mass, volume and myocardial scar assessment. Results: 148 participants completed the study protocol-61% male, with mean age of 64±8.2years. SAS was highest in those with cardiovascular disease without diabetes [10.1 (0-39.5)], followed by those with T2DM and CVD [4 (0-41.1)], then those with T2DM only [3.23 (0-19.4)] with healthy controls having the lowest atheroma score [2.4 (0-19.4)]. Both groups with a prior history of CVD had a higher SAS and left ventricular mass than those without (p<0.001 for both). However after accounting for known cardiovascular risk factors, only the SAS in the group with CVD without T2DM remained significantly elevated. 6% of the T2DM group had evidence of silent myocardial infarct, with this subcohort having a higher SAS than the remainder of the T2DM group [7.7 (4-19) vs. 2.8 (0-17), p=0.024]. Conclusions: Global atheroma burden was significantly higher in those with known cardiovascular disease and without diabetes but not in those with diabetes and cardiovascular disease suggesting that cardiovascular events may occur at a lower atheroma burden in diabetes.

Original languageEnglish
Article number122
Number of pages11
JournalCardiovascular Diabetology
Volume14
DOIs
Publication statusPublished - 18 Sep 2015

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Atherosclerotic Plaques
Heart Diseases
Cohort Studies
Cardiovascular Diseases
Type 2 Diabetes Mellitus
Magnetic Resonance Imaging
Image Enhancement
Body Burden
Gadolinium
Heart Ventricles
Cicatrix
Angiography
Pathologic Constriction
Myocardial Infarction

Keywords

  • Atheroma score
  • Atherosclerosis
  • Cardiovascular disease
  • CMR
  • LVA
  • Magnetic resonance angiography
  • T2DM
  • Type 2 diabetes mellitus
  • WB CVMR
  • Whole body MRI

Cite this

Duce, Suzanne L. ; Weir-McCall, Jonathan R. ; Gandy, Stephen J. ; Matthew, Shona Z. ; Cassidy, Deirdre B. ; McCormick, Lynne ; Rauchhaus, Petra ; Looker, Helen ; Colhoun, Helen M. ; Houston, J. Graeme. / Cohort comparison study of cardiac disease and atherosclerotic burden in type 2 diabetic adults using whole body cardiovascular magnetic resonance imaging. In: Cardiovascular Diabetology. 2015 ; Vol. 14.
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title = "Cohort comparison study of cardiac disease and atherosclerotic burden in type 2 diabetic adults using whole body cardiovascular magnetic resonance imaging",
abstract = "Background: Whole body cardiovascular MR (WB CVMR) combines whole body angiography and cardiac MR assessment. It is accepted that there is a high disease burden in patients with diabetes, however the quantification of the whole body atheroma burden in both arterial and cardiac disease has not been previously reported. In this study we compare the quantified atheroma burden in those individuals with and without diabetes by clinical cardiovascular disease (CVD) status. Methods: 158 participants underwent WB CVMR, and were categorised into one of four groups: (1) type 2 diabetes mellitus (T2DM) with CVD; (2) T2DM without CVD; (3) CVD without T2DM; (4) healthy controls. The arterial tree was subdivided into 31 segments and each scored according to the degree of stenosis. From this a standardised atheroma score (SAS) was calculated. Cardiac MR and late gadolinium enhancement images of the left ventricle were obtained for assessment of mass, volume and myocardial scar assessment. Results: 148 participants completed the study protocol-61{\%} male, with mean age of 64±8.2years. SAS was highest in those with cardiovascular disease without diabetes [10.1 (0-39.5)], followed by those with T2DM and CVD [4 (0-41.1)], then those with T2DM only [3.23 (0-19.4)] with healthy controls having the lowest atheroma score [2.4 (0-19.4)]. Both groups with a prior history of CVD had a higher SAS and left ventricular mass than those without (p<0.001 for both). However after accounting for known cardiovascular risk factors, only the SAS in the group with CVD without T2DM remained significantly elevated. 6{\%} of the T2DM group had evidence of silent myocardial infarct, with this subcohort having a higher SAS than the remainder of the T2DM group [7.7 (4-19) vs. 2.8 (0-17), p=0.024]. Conclusions: Global atheroma burden was significantly higher in those with known cardiovascular disease and without diabetes but not in those with diabetes and cardiovascular disease suggesting that cardiovascular events may occur at a lower atheroma burden in diabetes.",
keywords = "Atheroma score, Atherosclerosis, Cardiovascular disease, CMR, LVA, Magnetic resonance angiography, T2DM, Type 2 diabetes mellitus, WB CVMR, Whole body MRI",
author = "Duce, {Suzanne L.} and Weir-McCall, {Jonathan R.} and Gandy, {Stephen J.} and Matthew, {Shona Z.} and Cassidy, {Deirdre B.} and Lynne McCormick and Petra Rauchhaus and Helen Looker and Colhoun, {Helen M.} and Houston, {J. Graeme}",
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Cohort comparison study of cardiac disease and atherosclerotic burden in type 2 diabetic adults using whole body cardiovascular magnetic resonance imaging. / Duce, Suzanne L.; Weir-McCall, Jonathan R. (Lead / Corresponding author); Gandy, Stephen J.; Matthew, Shona Z.; Cassidy, Deirdre B.; McCormick, Lynne; Rauchhaus, Petra; Looker, Helen; Colhoun, Helen M.; Houston, J. Graeme.

In: Cardiovascular Diabetology, Vol. 14, 122, 18.09.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cohort comparison study of cardiac disease and atherosclerotic burden in type 2 diabetic adults using whole body cardiovascular magnetic resonance imaging

AU - Duce, Suzanne L.

AU - Weir-McCall, Jonathan R.

AU - Gandy, Stephen J.

AU - Matthew, Shona Z.

AU - Cassidy, Deirdre B.

AU - McCormick, Lynne

AU - Rauchhaus, Petra

AU - Looker, Helen

AU - Colhoun, Helen M.

AU - Houston, J. Graeme

PY - 2015/9/18

Y1 - 2015/9/18

N2 - Background: Whole body cardiovascular MR (WB CVMR) combines whole body angiography and cardiac MR assessment. It is accepted that there is a high disease burden in patients with diabetes, however the quantification of the whole body atheroma burden in both arterial and cardiac disease has not been previously reported. In this study we compare the quantified atheroma burden in those individuals with and without diabetes by clinical cardiovascular disease (CVD) status. Methods: 158 participants underwent WB CVMR, and were categorised into one of four groups: (1) type 2 diabetes mellitus (T2DM) with CVD; (2) T2DM without CVD; (3) CVD without T2DM; (4) healthy controls. The arterial tree was subdivided into 31 segments and each scored according to the degree of stenosis. From this a standardised atheroma score (SAS) was calculated. Cardiac MR and late gadolinium enhancement images of the left ventricle were obtained for assessment of mass, volume and myocardial scar assessment. Results: 148 participants completed the study protocol-61% male, with mean age of 64±8.2years. SAS was highest in those with cardiovascular disease without diabetes [10.1 (0-39.5)], followed by those with T2DM and CVD [4 (0-41.1)], then those with T2DM only [3.23 (0-19.4)] with healthy controls having the lowest atheroma score [2.4 (0-19.4)]. Both groups with a prior history of CVD had a higher SAS and left ventricular mass than those without (p<0.001 for both). However after accounting for known cardiovascular risk factors, only the SAS in the group with CVD without T2DM remained significantly elevated. 6% of the T2DM group had evidence of silent myocardial infarct, with this subcohort having a higher SAS than the remainder of the T2DM group [7.7 (4-19) vs. 2.8 (0-17), p=0.024]. Conclusions: Global atheroma burden was significantly higher in those with known cardiovascular disease and without diabetes but not in those with diabetes and cardiovascular disease suggesting that cardiovascular events may occur at a lower atheroma burden in diabetes.

AB - Background: Whole body cardiovascular MR (WB CVMR) combines whole body angiography and cardiac MR assessment. It is accepted that there is a high disease burden in patients with diabetes, however the quantification of the whole body atheroma burden in both arterial and cardiac disease has not been previously reported. In this study we compare the quantified atheroma burden in those individuals with and without diabetes by clinical cardiovascular disease (CVD) status. Methods: 158 participants underwent WB CVMR, and were categorised into one of four groups: (1) type 2 diabetes mellitus (T2DM) with CVD; (2) T2DM without CVD; (3) CVD without T2DM; (4) healthy controls. The arterial tree was subdivided into 31 segments and each scored according to the degree of stenosis. From this a standardised atheroma score (SAS) was calculated. Cardiac MR and late gadolinium enhancement images of the left ventricle were obtained for assessment of mass, volume and myocardial scar assessment. Results: 148 participants completed the study protocol-61% male, with mean age of 64±8.2years. SAS was highest in those with cardiovascular disease without diabetes [10.1 (0-39.5)], followed by those with T2DM and CVD [4 (0-41.1)], then those with T2DM only [3.23 (0-19.4)] with healthy controls having the lowest atheroma score [2.4 (0-19.4)]. Both groups with a prior history of CVD had a higher SAS and left ventricular mass than those without (p<0.001 for both). However after accounting for known cardiovascular risk factors, only the SAS in the group with CVD without T2DM remained significantly elevated. 6% of the T2DM group had evidence of silent myocardial infarct, with this subcohort having a higher SAS than the remainder of the T2DM group [7.7 (4-19) vs. 2.8 (0-17), p=0.024]. Conclusions: Global atheroma burden was significantly higher in those with known cardiovascular disease and without diabetes but not in those with diabetes and cardiovascular disease suggesting that cardiovascular events may occur at a lower atheroma burden in diabetes.

KW - Atheroma score

KW - Atherosclerosis

KW - Cardiovascular disease

KW - CMR

KW - LVA

KW - Magnetic resonance angiography

KW - T2DM

KW - Type 2 diabetes mellitus

KW - WB CVMR

KW - Whole body MRI

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U2 - 10.1186/s12933-015-0284-2

DO - 10.1186/s12933-015-0284-2

M3 - Article

VL - 14

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

SN - 1475-2840

M1 - 122

ER -