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Article: Cardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study

TitleCardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study
Authors
KeywordsStress cardiac magnetic resonance
Type 2 diabetes
Asymptomatic
High cardiovascular risk
Screening
Issue Date2020
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.cardiab.com/
Citation
Cardiovascular Diabetology, 2020, v. 19, p. article no. 42 How to Cite?
AbstractBackground: 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.
Persistent Identifierhttp://hdl.handle.net/10722/281872
ISSN
2018 Impact Factor: 5.948
2015 SCImago Journal Rankings: 1.757

 

DC FieldValueLanguage
dc.contributor.authorNg, M-Y-
dc.contributor.authorZHOU, W-
dc.contributor.authorVardhanabhuti, V-
dc.contributor.authorLee, C-H-
dc.contributor.authorYu, EYT-
dc.contributor.authorWan, EYF-
dc.contributor.authorChan, K-
dc.contributor.authorYan, AT-
dc.contributor.authorIp, T-P-
dc.contributor.authorYiu, K-H-
dc.contributor.authorWintersperger, BJ-
dc.date.accessioned2020-04-03T07:22:59Z-
dc.date.available2020-04-03T07:22:59Z-
dc.date.issued2020-
dc.identifier.citationCardiovascular Diabetology, 2020, v. 19, p. article no. 42-
dc.identifier.issn1475-2840-
dc.identifier.urihttp://hdl.handle.net/10722/281872-
dc.description.abstractBackground: 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.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.cardiab.com/-
dc.relation.ispartofCardiovascular Diabetology-
dc.rightsCardiovascular Diabetology. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectStress cardiac magnetic resonance-
dc.subjectType 2 diabetes-
dc.subjectAsymptomatic-
dc.subjectHigh cardiovascular risk-
dc.subjectScreening-
dc.titleCardiac magnetic resonance for asymptomatic patients with type 2 diabetes and cardiovascular high risk (CATCH): a pilot study-
dc.typeArticle-
dc.identifier.emailNg, M-Y: myng2@hku.hk-
dc.identifier.emailVardhanabhuti, V: varv@hku.hk-
dc.identifier.emailLee, C-H: pchlee@hku.hk-
dc.identifier.emailYu, EYT: ytyu@hku.hk-
dc.identifier.emailWan, EYF: yfwan@hku.hk-
dc.identifier.emailYiu, K-H: khkyiu@hku.hk-
dc.identifier.authorityNg, M-Y=rp01976-
dc.identifier.authorityVardhanabhuti, V=rp01900-
dc.identifier.authorityLee, C-H=rp02043-
dc.identifier.authorityYu, EYT=rp01693-
dc.identifier.authorityWan, EYF=rp02518-
dc.identifier.authorityYiu, K-H=rp01490-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12933-020-01019-2-
dc.identifier.hkuros309654-
dc.identifier.volume19-
dc.identifier.spagearticle no. 42-
dc.identifier.epagearticle no. 42-
dc.publisher.placeUnited Kingdom-

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