Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus
Diabetes mellitus can independently contribute to cardiovascular disease and represents a severe risk factor for premature development of cardiovascular disease. A three-fold higher mortality than the general population has been observed in type 1 diabetes mellitus whereas a two- to four-fold increa...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-06-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.672302/full |
| _version_ | 1818664408499355648 |
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| author | Sophie I. Mavrogeni Sophie I. Mavrogeni Flora Bacopoulou George Markousis-Mavrogenis Aikaterini Giannakopoulou Ourania Kariki Vasiliki Vartela Genovefa Kolovou Evangelia Charmandari Evangelia Charmandari George Chrousos George Chrousos |
| author_facet | Sophie I. Mavrogeni Sophie I. Mavrogeni Flora Bacopoulou George Markousis-Mavrogenis Aikaterini Giannakopoulou Ourania Kariki Vasiliki Vartela Genovefa Kolovou Evangelia Charmandari Evangelia Charmandari George Chrousos George Chrousos |
| author_sort | Sophie I. Mavrogeni |
| collection | DOAJ |
| description | Diabetes mellitus can independently contribute to cardiovascular disease and represents a severe risk factor for premature development of cardiovascular disease. A three-fold higher mortality than the general population has been observed in type 1 diabetes mellitus whereas a two- to four-fold increased probability to develop cardiovascular disease has been observed in type 2 diabetes mellitus. Cardiovascular magnetic resonance, a non-radiative modality, is superior to all other modalities in detecting myocardial infarction. The main cardiovascular magnetic resonance sequences used include a) balanced steady-state free precession (bSSFP) for function evaluation; b) T2-W for oedema detection; c) T1 W for ischemia detection during adenosine stress; and d) late gadolinium enhanced T1-W images (LGE), evaluated 15 min after injection of paramagnetic contrast agent gadolinium, which permit the diagnosis of replacement fibrosis, which appears white in the middle of suppressed, nulled myocardium. Although LGE is the technique of choice for diagnosis of replacement fibrosis, it cannot assess diffuse myocardial fibrosis. The application of T1 mapping (native or pre contrast and post contrast) allows identification of diffuse myocardial fibrosis, which is not detectable my other means. Native T1 and Contrast-enhanced T1 mapping are involved in the extracellular volume fraction (ECV) calculation. Recently, 1H-cardiovascular magnetic resonance spectroscopy has been applied to calculate the amount of myocardial triglycerides, but at the moment it is not part of the routine assessment of diabetes mellitus. The multifaceted nature of cardiovascular magnetic resonance has the great potential of concurrent evaluation of function and myocardial ischemia/fibrosis in the same examination and represents an indispensable tool for accurate diagnosis of cardiovascular disease in diabetes mellitus. |
| first_indexed | 2024-12-17T05:32:16Z |
| format | Article |
| id | doaj.art-76e4313a6bef45d6920ec89d9b5df28d |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-17T05:32:16Z |
| publishDate | 2021-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-76e4313a6bef45d6920ec89d9b5df28d2022-12-21T22:01:41ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-06-011210.3389/fendo.2021.672302672302Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes MellitusSophie I. Mavrogeni0Sophie I. Mavrogeni1Flora Bacopoulou2George Markousis-Mavrogenis3Aikaterini Giannakopoulou4Ourania Kariki5Vasiliki Vartela6Genovefa Kolovou7Evangelia Charmandari8Evangelia Charmandari9George Chrousos10George Chrousos11Department of Cardiology, Onassis Cardiac Surgery Center, Kallithea, GreeceUniversity Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, GreeceUniversity Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, GreeceDepartment of Cardiology, Onassis Cardiac Surgery Center, Kallithea, GreeceDepartment of Pediatric Cardiology, Aghia Sophia Children’s Hospital, Athens, GreeceDepartment of Cardiology, Onassis Cardiac Surgery Center, Kallithea, GreeceDepartment of Cardiology, Onassis Cardiac Surgery Center, Kallithea, GreeceDepartment of Cardiology, Onassis Cardiac Surgery Center, Kallithea, GreeceDivision of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, GreeceDivision of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, GreeceUniversity Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, GreeceDivision of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, GreeceDiabetes mellitus can independently contribute to cardiovascular disease and represents a severe risk factor for premature development of cardiovascular disease. A three-fold higher mortality than the general population has been observed in type 1 diabetes mellitus whereas a two- to four-fold increased probability to develop cardiovascular disease has been observed in type 2 diabetes mellitus. Cardiovascular magnetic resonance, a non-radiative modality, is superior to all other modalities in detecting myocardial infarction. The main cardiovascular magnetic resonance sequences used include a) balanced steady-state free precession (bSSFP) for function evaluation; b) T2-W for oedema detection; c) T1 W for ischemia detection during adenosine stress; and d) late gadolinium enhanced T1-W images (LGE), evaluated 15 min after injection of paramagnetic contrast agent gadolinium, which permit the diagnosis of replacement fibrosis, which appears white in the middle of suppressed, nulled myocardium. Although LGE is the technique of choice for diagnosis of replacement fibrosis, it cannot assess diffuse myocardial fibrosis. The application of T1 mapping (native or pre contrast and post contrast) allows identification of diffuse myocardial fibrosis, which is not detectable my other means. Native T1 and Contrast-enhanced T1 mapping are involved in the extracellular volume fraction (ECV) calculation. Recently, 1H-cardiovascular magnetic resonance spectroscopy has been applied to calculate the amount of myocardial triglycerides, but at the moment it is not part of the routine assessment of diabetes mellitus. The multifaceted nature of cardiovascular magnetic resonance has the great potential of concurrent evaluation of function and myocardial ischemia/fibrosis in the same examination and represents an indispensable tool for accurate diagnosis of cardiovascular disease in diabetes mellitus.https://www.frontiersin.org/articles/10.3389/fendo.2021.672302/fullcardiovascularmagnetic resonancecoronary artery diseaseheart failuremyocardial fibrosisdiabetes |
| spellingShingle | Sophie I. Mavrogeni Sophie I. Mavrogeni Flora Bacopoulou George Markousis-Mavrogenis Aikaterini Giannakopoulou Ourania Kariki Vasiliki Vartela Genovefa Kolovou Evangelia Charmandari Evangelia Charmandari George Chrousos George Chrousos Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus Frontiers in Endocrinology cardiovascular magnetic resonance coronary artery disease heart failure myocardial fibrosis diabetes |
| title | Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus |
| title_full | Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus |
| title_fullStr | Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus |
| title_full_unstemmed | Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus |
| title_short | Cardiovascular Magnetic Resonance as Pathophysiologic Tool in Diabetes Mellitus |
| title_sort | cardiovascular magnetic resonance as pathophysiologic tool in diabetes mellitus |
| topic | cardiovascular magnetic resonance coronary artery disease heart failure myocardial fibrosis diabetes |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.672302/full |
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