Cardiac magnetic resonance biomarkers revealed significantly elevated extracellular volume fraction (SMD 0.838) and higher prevalence of late gadolinium enhancement in patients with diabetes.
Meta-Analysis (n=3,900)
Do CMR biomarkers detect subclinical cardiovascular complications in patients with diabetes mellitus?
CMR biomarkers such as ECV, MPRI, and LGE can detect subclinical myocardial changes including diffuse fibrosis and microvascular dysfunction in patients with diabetes.
Estimación del efecto: SMD 0.838
valor p: p=0.003
Background Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in diabetes mellitus (DM). Cardiac magnetic resonance (CMR) biomarkers, such as T1 mapping, extracellular volume fraction (ECV), and perfusion indices, have emerged as promising tools for early detection of cardiovascular complications in diabetes. Methods We searched for original studies in PubMed, Scopus, Embase, ScienceDirect, and Google Scholar. Included studies enrolled patients with diabetes and were assessed using CMR biomarkers for diagnostic or prognostic outcomes. We extracted data related to study design, study population, CMR techniques, CMR biomarkers, and clinical outcomes. Random-effects meta-analyses were performed for outcomes reported in ≥2 studies. Results Nineteen studies ( n = 3,900+ patients) met inclusion criteria. CMR revealed subclinical myocardial changes in diabetic patients, including higher ECV, reduced strain, impaired perfusion, and increased prevalence of late gadolinium enhancement (LGE). Meta-analysis confirmed significantly elevated ECV (SMD = 0.838, p = 0.003), reduced myocardial perfusion reserve index (MPRI, SMD = 1.48, p = 0.033), and higher prevalence of LGE (SMD = 0.583, p 0.001), while native T1 showed no significant differences, between-study heterogeneity was low across pooled analyses (overall I 2 = 97.4%). The risk of bias was generally low to moderate. Conclusions CMR biomarkers for diffuse fibrosis, focal scarring, and microvascular dysfunction provide important insights into myocardial involvement in diabetes and may detect subclinical abnormalities. Nevertheless, due to a small number of studies, the cross-sectional nature of most of the studies, and methodological diversity, these results should be viewed as preliminary. More large-scale, standardized, prospective trials are needed to confirm their contribution to early detection and risk stratification.
Li et al. (Thu,) conducted a meta-analysis in Diabetes mellitus (n=3,900). Cardiac magnetic resonance (CMR) biomarkers vs. Healthy controls or conventional assessments was evaluated on Extracellular volume fraction (ECV) (SMD 0.838, p=0.003). Cardiac magnetic resonance biomarkers revealed significantly elevated extracellular volume fraction (SMD 0.838) and higher prevalence of late gadolinium enhancement in patients with diabetes.