ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1534236
This article is part of the Research TopicPreventing Cardiovascular Complications of Type 2 Diabetes - Volume IIView all 4 articles
Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarction
Provisionally accepted
- 1Tongji University, Shanghai, Shanghai Municipality, China
- 2The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Background: Extracellular volume (ECV) is an important marker of myocardial fibrosis.However, the prognostic role of ECV in diabetes patients is unknown. In addition, synthetic ECV without blood sampling has not been reported in diabetes cohorts. This study investigated the establishment and validation of synthetic ECV and its prognostic value in type 2 diabetes mellitus (T2DM) patients with acute myocardial infarction (AMI).Methods: This single-center retrospective study included T2DM patients with AMI who completed cardiac magnetic resonance (CMR) during hospitalization. The patients were randomly divided into a derivation group and a validation group. MACE included all-cause death, recurrent MI, stroke, or heart failure. ECV in integral (Integral ECV), non-myocardial infarction region (NMI-ECV), and myocardial infarction region (MI-ECV) was obtained by CMR.The study included 157 patients, with a median time from admission to CMR of 4 days. Bland-Altman and Pearson analysis showed good consistency and correlation between conventional ECV and synthetic ECV. Cox regression showed that Integral ECV (HR=1.07; 95%CI: 1.01 ~1.13, p = 0.023), MI-ECV (HR=1.03; 95%CI: 1.00 ~1.07, p = 0.024), and NMI-ECV (HR=1.07; 95%CI: 1.00 ~1.14, p = 0.039) were independently associated with MACE in different models. Kaplan-Meier analysis indicated that patients with a high synthetic ECV had a significantly higher MACE risk.Conclusions: Synthetic ECV is strongly consistent and correlated with conventional ECV in T2DM patients with AMI. Elevated synthetic ECV is an independent risk factor for MACE in T2DM patients with AMI.
Keywords: cardiac magnetic resonance, Synthetic Extracellular volume, diabetes, acute myocardial infarction, Major adverse cardiac events
Received: 25 Nov 2024; Accepted: 04 Jun 2025.
Copyright: © 2025 Chen, Qiu, Du, Liu, CHE, Chen and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
WENLIANG CHE, Tongji University, Shanghai, 200092, Shanghai Municipality, China
Wensu Chen, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Yuan Lu, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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