Assessment of left-ventricular diastolic function in diabetic patients: the role of cardiac MR imaging

To evaluate the reliability of cardiac magnetic resonance (CMR) imaging in diabetic patients with clinically suspected cardiomyopathy and to compare the consistency of CMR imaging with 2-dimensional echocardiography (2DE). Materials and methods: Twenty-one diabetic patients with clinically suspected cardiomyopathy were evaluated with CMR imaging and 2DE. Two observers for each modality performed the evaluation. Quantitative data (the ejection fraction, end-systolic volume, end-diastolic volume, left-ventricular mass index, and left-atrial volume index) were acquired from both observers. The data were compared for statistical agreement using the Bland-Altman test between the modalities. Results: The CMR examination and 2DE results were consistent with each other. There was strong agreement between the 2 methods. The intraclass correlation-coefficient comparison of the data from the 2 observers of each modality showed that the CMR observers' measurements were more consistent than the 2DE observers' measurements. Conclusion: This study demonstrates that compared with CMR, 2DE has much poorer reproducibility and much higher interobserver variability. Although 2DE is currently the noninvasive imaging technique used to assess diastolic function in diabetic patients, CMR imaging is emerging as a valuable alternative, having the unique potential of function analysis.