Magnetic resonance cold pressor test to investigate potential endothelial dysfunction in patients suffering from type 1 diabetes

Abstract

Background In its course, diabetes impairs microvascular function through endothelial dysfunction. As the response of myocardial perfusion to sympathetic stimulation through cold is modulated by endothelium‐related factors, an incipient endothelial dysfunction might be observed noninvasively by investigation of myocardial perfusion with a cold pressor test (CPT). This approach has been used in clinical MRI previously. Purpose To assess endothelial function of patients suffering from type 1 diabetes by MR CPT. Study Type Prospective cohort study. Subjects Twenty type 1 diabetics and 20 healthy volunteers. Field Strength/Sequence 3T, dynamic contrast enhanced perfusion (steady‐state free precession). Assessment Absolute quantitative myocardial perfusion values at rest and under CPT. Statistical Tests Kolmogorov–Smirnov test to determine normal distribution of the results. T ‐test for independent samples. Results Patients' mean myocardial perfusion was 0.68 cc/g/min at rest and 0.80 cc/g/min during CPT, respective values of 0.81 cc/g/min and 1.36 cc/g/min were found in healthy volunteers. Perfusion values differed significantly for CPT ( P < 0.01) but not for resting conditions ( P = 0.06). Data Conclusion This study demonstrated that endothelial function might be impaired in type 1 diabetes patients. This fosters the thesis that endothelial function may serve as an early biomarker for coronary artery disease in patients with type 1 diabetes while these patients are still clinically asymptomatic. Level of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;48:1595–1601