Cardiovascular Magnetic Resonance Imaging in Cardiometabolic Disease

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atmire.migration.oldid4044
dc.contributor.advisorAnderson, Todd
dc.contributor.advisorFriedrich, Matthias
dc.contributor.authorSchmidt, Anna
dc.contributor.committeememberWhite, James
dc.contributor.committeememberPacaud, Danièle
dc.contributor.committeememberLau, David
dc.date.accessioned2016-01-26T21:58:23Z
dc.date.available2016-01-26T21:58:23Z
dc.date.issued2016-01-26
dc.date.submitted2016en
dc.description.abstractThe unrelenting incidence of obesity and type 2 diabetes has become a global public health concern. Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in these cohorts. Cardiovascular Magnetic Resonance (CMR) imaging is a robust imaging modality with techniques to provide sensitive detection of early cardiovascular changes in obesity and diabetes. In a prospective study of obese adolescents (n=11, 10 to 20 years old) and a healthy weight control group (n=14), we found obesity was associated with increases in Left ventricular (LV) mass, LV wall thickness and mass:volume ratio. In this “early stage” of remodeling, these structural changes were not associated with elevations in Native T1, a surrogate marker of tissue fibrosis. Strain analysis, by novel CMR tissue tracking analysis, revealed a hyper-contractile state, likely representing a combined contribution of elevated systolic blood pressure with compensatory myocyte hypertrophy. Obese subjects were additionally enrolled in a comprehensive 6-month lifestyle intervention; subjects did not experience weight loss or any change in cardiac parameters after 6 months. Further along the natural history of CVD as related to metabolic disease, the second study looked to examine possible sub-clinical changes in the hearts of otherwise healthy diabetic patients. This study examined twenty-eight healthy type 2 diabetic patients without any observable vascular complications. The complementary use of CMR-based T1 mapping and 3-dimensional strain analysis demonstrated expansion of the extracellular matrix and a reduction in global longitudinal strain. In the endpoint of the cardiometabolic disease spectrum, we analyzed individuals with known or suspected Coronary Artery Disease. This study explored the relationship between intra-thoracic fat volume (ITFV) and 4D myocardial strain-based markers of adverse remodeling. In non-infarcted myocardium, ITFV is associated with reductions in myocardial strain. These findings suggest ITFV to be a potentially important marker of adverse ventricular remodeling. The findings of these three studies suggest a capacity of contemporary CMR to identify early changes in cardiometabolic disease and also lend insight into the progression of diabetic heart disease. CMR provides a non-invasive, accurate and reproducible imaging modality with the potential to be useful in screening and CVD risk-stratification.en_US
dc.identifier.citationSchmidt, A. (2016). Cardiovascular Magnetic Resonance Imaging in Cardiometabolic Disease (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/25216en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/25216
dc.identifier.urihttp://hdl.handle.net/11023/2776
dc.language.isoeng
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectBiophysics--Medical
dc.subject.classificationImagingen_US
dc.subject.classificationDiabetesen_US
dc.subject.classificationCardiovascular Diseaseen_US
dc.subject.classificationObesityen_US
dc.titleCardiovascular Magnetic Resonance Imaging in Cardiometabolic Disease
dc.typedoctoral thesis
thesis.degree.disciplineCardiovascular & Respiratory Sciences
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameDoctor of Philosophy (PhD)
ucalgary.item.requestcopytrue
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