Why the study?
Does magnetic resonance cold pressor testing detect impaired myocardial perfusion indicative of endothelial dysfunction in patients with type 1 diabetes compared to healthy volunteers?
Does magnetic resonance cold pressor testing detect impaired myocardial perfusion indicative of endothelial dysfunction in patients with type 1 diabetes compared to healthy volunteers?
MR cold pressor testing demonstrates blunted myocardial perfusion responses in asymptomatic type 1 diabetes patients, suggesting its potential utility as an early noninvasive imaging biomarker for endothelial dysfunction.
Suggests MR CPT as potential early biomarker of endothelial dysfunction in type 1 diabetes; hypothesis-generating, requires prospective validation before clinical use.
BACKGROUND: In its course, diabetes impairs microvascular function through endothelial dysfunction. As the response of myocardial perfusion to sympathetic stimulation through cold is modulated by endothelium-related factors, an incipient endothelial dysfunction might be observed noninvasively by investigation of myocardial perfusion with a cold pressor test (CPT). This approach has been used in clinical MRI previously. PURPOSE: To assess endothelial function of patients suffering from type 1 diabetes by MR CPT. STUDY TYPE: Prospective cohort study. SUBJECTS: Twenty type 1 diabetics and 20 healthy volunteers. FIELD STRENGTH/SEQUENCE: 3T, dynamic contrast enhanced perfusion (steady-state free precession). ASSESSMENT: Absolute quantitative myocardial perfusion values at rest and under CPT. STATISTICAL TESTS: Kolmogorov-Smirnov test to determine normal distribution of the results. T-test for independent samples. RESULTS: Patients' mean myocardial perfusion was 0.68 cc/g/min at rest and 0.80 cc/g/min during CPT, respective values of 0.81 cc/g/min and 1.36 cc/g/min were found in healthy volunteers. Perfusion values differed significantly for CPT (P < 0.01) but not for resting conditions (P = 0.06). DATA CONCLUSION: This study demonstrated that endothelial function might be impaired in type 1 diabetes patients. This fosters the thesis that endothelial function may serve as an early biomarker for coronary artery disease in patients with type 1 diabetes while these patients are still clinically asymptomatic. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;48:1595-1601.
No takes yet. Share an insight, caveat, or question.
Weng et al. (2018) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: