Predictive value of myocardial strain parameters of cardiac magnetic resonance imaging to diabetic dilated cardiomyopathy

Li Xiaoying; Li Yong; Liu Xiaocheng

doi:10.3969/j.issn.1674-4055.2025.07.05

Abstract：Objective To investigate the predictive value of myocardial strain parameters of cardiac magnetic resonance imaging(CMRI)in patients with diabetic dilated cardiomyopathy(DCM).Methods DCM patients(n=161)were selected and given CMRI examination in Department of Medical Imaging of the First Affiliated Hospital of Hebei North University from Apr.2019 to Apr.2023.The patients were followed up for 12 months,and with death occurred within this period considered as a poor prognosis.Based on the occurrence of poor prognosis events,they were divided into survival group(n=130)and death group(n=31).CMRI myocardial strain parameters[global longitudinal strain(GLS),global circumstantial strain(GCS),global radial strain(GRS)]and indexes of heart function[left ventricular ejection fraction(LVEF),left atrial inner diameter(LAD),left ventricular end-systolic diameter(LVEDd)]were compared between 2 groups.The correlation among CMRI myocardial strain parameters and indexes of heart function was analyzed.The clinical data were compared between 2 groups.The risk factors of poor prognosis were analyzed by using Logistic regression analysis in DCM patients.The predictive value of CMRI myocardial strain parameters to poor prognosis was analyzed by using ROC curve.Results Compared with survival group,GLS,GCS,GRS and LVEF were lower,and LAD and LVEDd were higher in death group than those in survival group(P＜0.05).The results of Pearson correlation analysis showed that GLS,GCS and GRS were correlated to LEVF,and negatively correlated to LAD and LVEDd(P＜0.05).The level of N-terminal pro-brain natriuretic peptide(NT-proBNP)and percentage of grade Ⅳ in heart function grading were higher in death group than those in survival group(P＜0.05).The results of multi-factor Logistic regression analysis showed that increased NT-proBNP was an independent risk factor for death,and higher LVEF,GLS and GCS were protective factors(P＜0.05).The results of ROC curve analysis showed that,in predicting death in DCM patients,AUC of GLS was 0.788(95％CI:0.716～0.848),AUC of GCS was 0.793(95％CI:0.722～0.853),and AUC of GLS combined with GCS was 0.924(95％CI:0.871～0.960,P＜0.05).Conclusion In DCM patients with poor prognosis,GLS and GCS are lower,which are influence factors for poor prognosis in DCM patients,and GLS combined with GCS has a higher predictive value to prognosis.