CMR in Type 2 Diabetes Mellitus Patients
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:
- 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.
- 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
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
-
Slagelse, Denmark, 4200
- The diabetes outpatient clinic, Slagelse Hospital, Denmark
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
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
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
T2DM
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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
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
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Echocardiography
Time Frame: Cross-sectional so at baseline
|
Systolic function
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Cross-sectional so at baseline
|
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Blod samples
Time Frame: Cross-sectional so at baseline
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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
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Martin H Soerensen, DM, Slagelse Hospital
Publications and helpful links
General Publications
- Bojer AS, Sorensen MH, Vejlstrup N, Goetze JP, Gaede P, Madsen PL. Distinct non-ischemic myocardial late gadolinium enhancement lesions in patients with type 2 diabetes. Cardiovasc Diabetol. 2020 Oct 22;19(1):184. doi: 10.1186/s12933-020-01160-y.
- Sorensen MH, Bojer AS, Jorgensen NR, Broadbent DA, Plein S, Madsen PL, Gaede P. Fibroblast growth factor-23 is associated with imaging markers of diabetic cardiomyopathy and anti-diabetic therapeutics. Cardiovasc Diabetol. 2020 Sep 30;19(1):158. doi: 10.1186/s12933-020-01135-z.
- Sorensen MH, Bojer AS, Pontoppidan JRN, Broadbent DA, Plein S, Madsen PL, Gaede P. Reduced Myocardial Perfusion Reserve in Type 2 Diabetes Is Caused by Increased Perfusion at Rest and Decreased Maximal Perfusion During Stress. Diabetes Care. 2020 Jun;43(6):1285-1292. doi: 10.2337/dc19-2172. Epub 2020 Mar 19.
- Sorensen MH, Bojer AS, Broadbent DA, Plein S, Madsen PL, Gaede P. Cardiac perfusion, structure, and function in type 2 diabetes mellitus with and without diabetic complications. Eur Heart J Cardiovasc Imaging. 2020 Aug 1;21(8):887-895. doi: 10.1093/ehjci/jez266.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SJ-490
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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