Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study
Abstract Background Stress cardiovascular magnetic resonance (CMR) to screen for silent myocardial ischaemia in asymptomatic high risk patients with type 2 diabetes mellitus (DM) has never been performed, and its effectiveness is unknown. Our aim was to determine the feasibility of a screening progr...
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doaj-fbe36efcd2cd494ea25a088d16b2ea442020-11-25T02:06:16ZengBMCCardiovascular Diabetology1475-28402020-03-0119111110.1186/s12933-020-01019-2Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot studyMing-Yen Ng0Wenli Zhou1Varut Vardhanabhuti2Chi-Ho Lee3Esther Yee Tak Yu4Eric Yuk Fai Wan5Kit Chan6Andrew T. Yan7Tai-Pang Ip8Kai-Hang Yiu9Bernd J. Wintersperger10Department of Diagnostic Radiology, The University of Hong KongDepartment of Diagnostic Radiology, The University of Hong KongDepartment of Diagnostic Radiology, The University of Hong KongDepartment of Medicine, The University of Hong KongDepartment of Family Medicine and Primary Care, The University of Hong KongDepartment of Family Medicine and Primary Care, The University of Hong KongDepartment of Cardiology, The University of Hong Kong-Shenzhen HospitalDepartments of Medicine and Medical Imaging, St. Michael’s HospitalDepartment of Medicine, Tung Wah HospitalDepartment of Medicine, The University of Hong KongDepartment of Medical Imaging, University of TorontoAbstract Background Stress cardiovascular magnetic resonance (CMR) to screen for silent myocardial ischaemia in asymptomatic high risk patients with type 2 diabetes mellitus (DM) has never been performed, and its effectiveness is unknown. Our aim was to determine the feasibility of a screening programme using stress CMR by obtaining preliminary data on the prevalence of silent ischaemia caused by obstructive coronary artery disease (CAD) and quantify myocardial perfusion in asymptomatic high risk patients with type 2 diabetes. Methods In this prospective cohort study, we recruited 63 asymptomatic DM patients (mean age 66 years ± 4.4 years; 77.8% male); with Framingham risk score ≥ 20% from 3 sites from June 2017 to August 2018. Normal volunteers were recruited to determine normal global myocardial perfusion reserve index (MPRI). Adenosine stress CMR and global MPRI was performed and measured in all subjects. Positive stress CMR cases were referred for catheter coronary angiography (CCA) with/without fractional flow reserve (FFR) measurements. Positive CCA was defined as an FFR ≤ 0.8 or coronary narrowing ≥ 70%. Patients were followed up for major adverse cardiovascular events. Prevalence is presented as patient numbers and percentage. Mann–Whitney U test was used to compare global MPRI between patients and normal volunteers. Results 13 patients had positive stress CMR with positive CCA (20.6% of patient population), while 9 patients with positive stress CMR examinations had a negative CCA. 5 patients (7.9%) had infarcts detected of which 2 patients had no stress perfusion defects. 12 patients had coronary artery stents inserted, whilst 1 patient declined stent placement. DM patients had lower global MPRI than normal volunteers (n = 7) (1.43 ± 0.27 vs 1.83 ± 0.31 respectively; p < 0.01). After a median follow-up of 653 days, there was no death, heart failure, acute coronary syndrome hospitalisation or stroke. Conclusion 20.6% of asymptomatic DM patients (with Framingham risk ≥ 20%) had silent obstructive CAD. Furthermore, asymptomatic patients have reduced global MPRI than normal volunteers. Trial Registration: ClinicalTrials.gov Registration Number: NCT03263728 on 28th August 2017; https://clinicaltrials.gov/ct2/show/NCT03263728 .http://link.springer.com/article/10.1186/s12933-020-01019-2Stress cardiac magnetic resonanceType 2 diabetesAsymptomaticHigh cardiovascular riskScreening |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ming-Yen Ng Wenli Zhou Varut Vardhanabhuti Chi-Ho Lee Esther Yee Tak Yu Eric Yuk Fai Wan Kit Chan Andrew T. Yan Tai-Pang Ip Kai-Hang Yiu Bernd J. Wintersperger |
spellingShingle |
Ming-Yen Ng Wenli Zhou Varut Vardhanabhuti Chi-Ho Lee Esther Yee Tak Yu Eric Yuk Fai Wan Kit Chan Andrew T. Yan Tai-Pang Ip Kai-Hang Yiu Bernd J. Wintersperger Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study Cardiovascular Diabetology Stress cardiac magnetic resonance Type 2 diabetes Asymptomatic High cardiovascular risk Screening |
author_facet |
Ming-Yen Ng Wenli Zhou Varut Vardhanabhuti Chi-Ho Lee Esther Yee Tak Yu Eric Yuk Fai Wan Kit Chan Andrew T. Yan Tai-Pang Ip Kai-Hang Yiu Bernd J. Wintersperger |
author_sort |
Ming-Yen Ng |
title |
Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study |
title_short |
Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study |
title_full |
Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study |
title_fullStr |
Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study |
title_full_unstemmed |
Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study |
title_sort |
cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (catch): a pilot study |
publisher |
BMC |
series |
Cardiovascular Diabetology |
issn |
1475-2840 |
publishDate |
2020-03-01 |
description |
Abstract Background Stress cardiovascular magnetic resonance (CMR) to screen for silent myocardial ischaemia in asymptomatic high risk patients with type 2 diabetes mellitus (DM) has never been performed, and its effectiveness is unknown. Our aim was to determine the feasibility of a screening programme using stress CMR by obtaining preliminary data on the prevalence of silent ischaemia caused by obstructive coronary artery disease (CAD) and quantify myocardial perfusion in asymptomatic high risk patients with type 2 diabetes. Methods In this prospective cohort study, we recruited 63 asymptomatic DM patients (mean age 66 years ± 4.4 years; 77.8% male); with Framingham risk score ≥ 20% from 3 sites from June 2017 to August 2018. Normal volunteers were recruited to determine normal global myocardial perfusion reserve index (MPRI). Adenosine stress CMR and global MPRI was performed and measured in all subjects. Positive stress CMR cases were referred for catheter coronary angiography (CCA) with/without fractional flow reserve (FFR) measurements. Positive CCA was defined as an FFR ≤ 0.8 or coronary narrowing ≥ 70%. Patients were followed up for major adverse cardiovascular events. Prevalence is presented as patient numbers and percentage. Mann–Whitney U test was used to compare global MPRI between patients and normal volunteers. Results 13 patients had positive stress CMR with positive CCA (20.6% of patient population), while 9 patients with positive stress CMR examinations had a negative CCA. 5 patients (7.9%) had infarcts detected of which 2 patients had no stress perfusion defects. 12 patients had coronary artery stents inserted, whilst 1 patient declined stent placement. DM patients had lower global MPRI than normal volunteers (n = 7) (1.43 ± 0.27 vs 1.83 ± 0.31 respectively; p < 0.01). After a median follow-up of 653 days, there was no death, heart failure, acute coronary syndrome hospitalisation or stroke. Conclusion 20.6% of asymptomatic DM patients (with Framingham risk ≥ 20%) had silent obstructive CAD. Furthermore, asymptomatic patients have reduced global MPRI than normal volunteers. Trial Registration: ClinicalTrials.gov Registration Number: NCT03263728 on 28th August 2017; https://clinicaltrials.gov/ct2/show/NCT03263728 . |
topic |
Stress cardiac magnetic resonance Type 2 diabetes Asymptomatic High cardiovascular risk Screening |
url |
http://link.springer.com/article/10.1186/s12933-020-01019-2 |
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