Unveiling Myocardial Microstructure Shifts: Exploring the Impact of Diabetes in Stable CAD Patients through CMR T1 Mapping

Abstract Background: This study investigates myocardial structural changes in stable coronary artery disease (CAD) patients with type 2 diabetes using cardiac magnetic resonance (CMR) strain and T1 mapping. Methods: A total of 155 stable CAD patients underwent CMR examination, including LV morphology and function assessment, late gadolinium enhancement (LGE), and feature tracking (CMR-FT) for LV global longitudinal, circumferential, and radial strain. T1 mapping with extracellular volume (ECV) evaluation was also performed. Results: Among the enrolled patients, 67 had type 2 diabetes. Diabetic patients exhibited impaired LV strain and higher ECV compared to non-diabetics. Multivariate analysis identified type 2 diabetes as an independent predictor of increased ECV and decreased strain. Conclusions: CMR-based T1 mapping highlights impaired myocardial contractility, elevated ECV, and potential interstitial fibrosis in diabetic patients with stable CAD. This suggests a significant impact of diabetes on myocardial health beyond CAD, emphasizing the importance of comprehensive assessment in these individuals.