OBJECTIVE:To compare magnetic resonance imaging-derived right ventricular (RV) dimensions and function between men with type 2 diabetes and healthy subjects, and to relate these parameters to left ventricular (LV) dimensions and function. RESEARCH DESIGN AND METHODS:RV and LV volumes and functions were assessed in 78 men with uncomplicated type 2 diabetes and 28 healthy men within the same range of age using magnetic resonance imaging. Steady-state free precession sequences were used to assess ventricular dimensions. Flow velocity mapping across the pulmonary valve and tricuspid valve was used to assess RV outflow and diastolic filling patterns, respectively. Univariate general linear models were used for statistical analyses. RESULTS:RV end-diastolic volume was significantly decreased in patients compared with healthy subjects after adjustment for BMI and pulse pressure (177 ± 28 mL vs. 197 ± 47 mL, P < 0.01). RV systolic function was impaired: peak ejection rate across the pulmonary valve was decreased (433 ± 54 mL/s vs. 463 ± 71 mL/s, P < 0.01) and pulmonary flow acceleration time was longer (124 ± 17 ms vs. 115 ± 25 ms, P < 0.05). Indexes of RV diastolic function were impaired: peak filling rate and peak deceleration gradient of the early filling phase were 315 ± 63 mL/s vs. 356 ± 90 mL/s (P < 0.01) and 2.3 ± 0.8 mL/s(2) × 10(-3) vs. 2.8 ± 0.8 mL/s(2) × 10(-3) (P < 0.01), respectively. All RV parameters were strongly associated with its corresponding LV parameter (P < 0.001). CONCLUSIONS:Diabetic cardiomyopathy affects the right ventricle, as demonstrated by RV remodeling and impaired systolic and diastolic functions in men with type 2 diabetes, in a similar manner as changes in LV dimensions and functions. These observations suggest that RV impairment might be a component of the diabetic cardiomyopathy phenotype.

译文

目的:比较2型糖尿病男性和健康受试者的磁共振成像得出的右心室(RV)尺寸和功能,并将这些参数与左心室(LV)尺寸和功能相关联。
研究设计和方法:使用磁共振成像技术评估了78例无并发症2型糖尿病的男性和28例同一年龄段健康男性的RV和LV容量及功能。稳态自由进动序列用于评估心室尺寸。跨肺动脉瓣和三尖瓣的流速图分别用于评估RV流出和舒张期充盈模式。单变量一般线性模型用于统计分析。
结果:校正BMI和脉压后,与健康受试者相比,RV患者舒张末期容积显着降低(177±28 mL vs. 197±47 mL,P <0.01)。右室收缩功能受损:跨肺动脉瓣的峰值射血率降低(433±54 mL / s与463±71 mL / s,P <0.01),肺血流加速时间更长(124±17 ms与115) ±25毫秒,P <0.05)。 RV舒张功能指标受损:早期充盈期的峰值充盈率和峰值减速度梯度为315±63 mL / s对356±90 mL / s(P <0.01)和2.3±0.8 mL / s(2) ×10(-3)与2.8±0.8 mL / s(2)×10(-3)(P <0.01)。所有RV参数均与其相应的LV参数密切相关(P <0.001)。
结论:糖尿病性心肌病会影响右心室,如右室重构和2型糖尿病男性收缩压和舒张功能受损所证实的,其方式与LV尺寸和功能的改变类似。这些观察结果表明,RV损伤可能是糖尿病性心肌病表型的一部分。

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