Cardiac magnetic resonance feature tracking for quantifying right ventricular deformation in type 2 diabetes mellitus patients

Figure 1. CMR feature tracking using cmr42 (Circle Cardiovascular Imaging Inc., Calgary, Canada) in short-axis, and four-chamber long-axis cine images at the end-diastole (A,B) and end-systole (C,D). The yellow and cyan curves delineate the endocardial and epicardial contours, respectively. The yellow dots represent the right ventricle myocardial voxel points, and the yellow short line on the images shows the tracking of the ventricle myocardial voxel points. The orange line is used to define the base and apex of tricuspid valve plane, and the apical plane. Abbreviations: CMR, cardiovascular magnetic resonance; T2DM: type 2 diabetes mellitus.

Figure 2. Box-and-whisker plot for comparison of global longitudinal PS, PSSR, PDSR (A,D,G), circumferential PS, PSSR, PDSR (B,E,H), and radial PS, PSSR, PDSR (C,F,I) in control subjects versus T2DM patients with preserved (T2DM1) and impaired RVEF (T2DM2). Kruskal-Wallis test was used to assess the differences in continuous variables among the three groups. Box plot: box length represents the interquartile range; horizontal box line represents the median; whiskers represent the maximum and minimum values; asterisk denotes P < 0.05 compared to controls; section denotes P < 0.05 T2DM compared to T2DM patients with normal RVEF. T2DM indicates, type 2 diabetes mellitus; RVEF, right ventricular ejection fraction; PS, peak strain; PSSR, peak systolic strain rate; PDSR, peak diastolic strain rate.

Figure 3. Scattergrams show the results of Pearson correlation analysis between LV mass and global (A) longitudinal, and (B) circumferential peak strain measurements.

Figure 4. Bland–Altman plots with limits of agreement (95% confidence intervals) demonstrating the intra-observer (A–C) and inter-observer (D–F) reproducibility of CMR myocardial feature tracking strain parameters: GRPS = global radial peak strain; GCPS = global circumferential peak strain; GLPS = global longitudinal peak strain. Solid lines represent bias (blue) and 95% limits of agreement (orange).

Figure 5. ROC analysis of global longitudinal PS (blue), circumferential PS (orange), and radial PS (green) between patients with T2DM and controls. Abbreviations: T2DM, type 2 diabetes mellitus; PS, peak strain; ROC, receiver operating characteristic.