CMR in Type 2 Diabetes Mellitus Patients

September 18, 2019 updated by: Annemie Stege Bojer, Slagelse Hospital

Cardiac Magnetic Resonance Imaging in Type 2 Diabetes Mellitus: The Mechanisms of Cardiac Function and Perfusion Dysfunction

The study will be performed as a cross-sectional survey. 300 Type 2 diabetes patients (T2DM), with or without known cardiovascular disease, will be recruited from the diabetes outpatient clinic, Slagelse Hospital. The patients will undergo echocardiography, Cardiac magnetic resonance imaging (CMR), clinical examination and will be asked to fill out questionnaires.

This study project sets out to answer the following hypotheses:

  1. Patients with T2DM have an increased risk of developing diastolic dysfunction. Using CMR, the investigators wish to measure left ventricle peak filling rate and passive atrial emptying fraction as a measure of cardiac diastolic function. The investigators hypothesize that classic T2DM markers such as levels of urinary albumin excretion, retinopathy, autonomic neuropathy, hypertension, dyslipidemia, elevated HgbA1c, T2DM duration, etc. are associated with pathological findings by CMR.
  2. Patients with T2DM have impaired left ventricle myocardial perfusion as determined by gadolinium contrast CMR. The investigators hypothesize that the classic markers and risk factors mentioned above, are associated with left ventricle myocardial hypoperfusion as determined by gadolinium contrast CMR.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Actual)

296

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Slagelse, Denmark, 4200
        • The diabetes outpatient clinic, Slagelse Hospital, Denmark

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

300 T2DM patients, with or without known cardiovascular disease, will be recruited from the diabetes outpatient clinic, Slagelse Hospital.

The patients will be divided into groups depending on their diabetes complication status. Individual groups of patients with fx. +/- retinopathy, +/- autonomous neuropathy, +/- hypertension, normo-/mikro-/makroalbuminuria will be compared.

Description

Inclusion Criteria:

  • Male or female patient fully capable of informed consent
  • Informed consent
  • T2DM
  • Age 18-80 (both years included)

Exclusion Criteria:

  • Contraindications to CMR (pacemakers/ICD-units, cochlear implants)
  • Lack of consent
  • Atrial fibrillation
  • eGFR < 30 ml/min/1,73m2 (only exclusion criteria for gadolinium contrast study)
  • Women of childbearing potential who are not on acceptable contraception
  • Severe claustrophobia (only contraindication for CMR but can undergo echocardiography and other examinations)
  • Contraindications to adenosine: history of significant bronchial asthma, 2nd or 3rd degree AV-block, severe hypotension, long QT-syndrome, unstable angina pectoris, sinus node dysfunction, incompensated heart failure
  • Contraindications to glycopyrrolate: closed-angle glaucoma, prostate hyperplasia, tachycardia, bladder atony, cardia insufficiency, non-congenital pylorus stenosis and gastroparesis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
T2DM
An extensive explorative CMR protocol, including time/volume curves of LV and LA, rest and stress perfusion (with Adenosin) and time/volume curve of LA after chronotropic stress with Glycopyrrolate, further flow measurements and T1 mapping.
Standard measurements and strain.
HbA1c, Glucose, Hgb, Creatinin, Sodium, Potassium, Total cholesterol, LDL cholesterol, HDL cholesterol, Free fatty acids, ALAT, Urinary albumin, NT-proBNP, ANP, suPAR, Copeptin, Proendothelin, proCNP, Soluble ST2, Galectin-3

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
On CMR; left ventricle peak filling rate (ml/s)
Time Frame: Cross-sectional so at baseline
Measure for cardiac diastolic function; including measurements at rest and after glycopyrrolate chronotropic stress
Cross-sectional so at baseline
On CMR, LV myocardial perfusion
Time Frame: Cross-sectional so at baseline
Including measurements at rest and with Adenosin stress
Cross-sectional so at baseline
On CMR; passive atrial emptying fraction (%) as a measure for cardiac diastolic function
Time Frame: Cross-sectional so at baseline
Measure for cardiac diastolic function; including measurements at rest and after glycopyrrolate chronotropic stress
Cross-sectional so at baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Echocardiography
Time Frame: Cross-sectional so at baseline
Systolic function
Cross-sectional so at baseline
Blod samples
Time Frame: Cross-sectional so at baseline
NT-proBNP, ANP, suPAR, Copeptin, Proendothelin, proCNP, Soluble ST2, Galectin-3
Cross-sectional so at baseline
Echocardiography
Time Frame: Cross-sectional so at baseline
Diastolic function
Cross-sectional so at baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Martin H Soerensen, DM, Slagelse Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2016

Primary Completion (Actual)

July 1, 2019

Study Completion (Actual)

July 1, 2019

Study Registration Dates

First Submitted

February 8, 2016

First Submitted That Met QC Criteria

February 11, 2016

First Posted (Estimate)

February 18, 2016

Study Record Updates

Last Update Posted (Actual)

September 19, 2019

Last Update Submitted That Met QC Criteria

September 18, 2019

Last Verified

September 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • SJ-490

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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