Int J Cardiovasc Imaging. 2026 Aug 3. doi: 10.1007/s10554-026-03789-4. Online ahead of print.
ABSTRACT
This study aimed to investigate the severity of myocardial fibrosis in patients with coronary heart disease (CHD) combined with diabetes mellitus (DM) using cardiovascular magnetic resonance (CMR) T1 mapping technique. This study enrolled 146 patients with CHD who underwent CMR. 96 patients had CHD without DM [CHD(DM-)], and 50 patients had CHD with DM [CHD(DM+)] according to whether they had DM or not. CMR-related parameters were also measured, including left ventricular (LV) cardiac function, T1 mapping, global strain, and late gadolinium enhancement. Patients were further divided into four subgroups based on the presence or absence of heart failure (HF): CHD (DM+) with HF, CHD (DM+) without HF, CHD (DM-) with HF, and CHD (DM-) without HF. The determinants of myocardial fibrosis in patients with CHD and CHD(DM+) were determined by multivariate linear regression analysis. Both native T1 and extracellular volume fraction (ECV) were significantly higher in patients with CHD (DM+) compared with those with CHD (DM-) [native T1: 1263.52 ± 69.19 vs. 1237.62 ± 62.11 and ECV: 33.95 (31.49, 37.62) vs. 32.21 (28.63, 35.7), respectively, p < 0.05]. While LV functional parameters, global peak strain, and late gadolinium enhancement were not significantly different between CHD (DM+) and CHD (DM-) patients. DM is an independent determinant of elevated native T1 and ECV in patients with CHD. In CHD and CHD (DM+), native T1 and ECV were significantly correlated with N-terminal pro-brain natriuretic peptide and LV ejection fraction. Meanwhile, native T1 and ECV were higher in patients with CHD (DM+) with HF than in those with CHD (DM+) without HF (p < 0.05). Elevated CMR native T1 and ECV values indicate that DM acts as an independent determinant in exacerbating myocardial fibrosis among CHD patients. Moreover, in patients with CHD combined with DM who developed HF, native T1 and ECV values were further increased, suggesting that the combination of DM and HF further aggravates myocardial fibrosis severity in CHD patients.
PMID:42545612 | DOI:10.1007/s10554-026-03789-4