Diabetic cardiomyopathy (DCM) is defined as myocardial dysfunction in the absence of valvular dysfunction, coronary artery disease, and hypertension. It progresses from diastolic dysfunction at the early stages to systolic impairment ultimately leading to pump failure.The first aim of this study will be to assess the right ventricular (RV) involvement in DCM in terms of ventricular size, contractile impairment, diastolic relaxation dysfunction and myocardial tissue changes in patients with type-2 diabetes.The second aim will be to investigate gender differences in the morphological, functional and tissue alterations of RV, since the gender determines differences not only in determination and resistance to metabolic, microcirculatory and inflammatory insult, but also different fibrosis regulation and hypertrophic remodelling. Further aims will be to assess correlations between right and left ventricular involvement and to identify a cluster of circulating markers predicting of RV involvement. If the research contract will be assigned, a further aim will be to generate a computational model of right and left ventricular 3D geometry (ventricular 3D shape and deformation over the cardiac cicle), which may provide an additional insight in the deep understanding of ventricular remodelling mechanisms and early prediction of ventricular deterioration.
In order to achieve the proposed aims we will perform a observational, case-control study by retrospectively enrolling 166 diabetic patients already subjected to cardiac magnetic resonance (CMR) examination at the beginning of two research trials (59 from CECSID and 107 from RECOGITO trial) and 60 non-diabetic controls selected specifically for this study. We will re-analysed the CMR exams using the latest release of a dedicated software that enables a sophisticated analysis of myocardial deformation during systolic contraction and diastolic relaxation (tissue tracking) and will correlate with clinical and laboratory data.
