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• Clinical Article •
A comparative study of left and right ventricular function in hypertensive patients with and without diabetes mellitus based on cardiac magnetic resonance feature tracking
WU Yongshun  BAO Mengyuan  ZHANG Linxin  QI Haicheng  XING Yan 

DOI:10.12015/issn.1674-8034.2026.05.011.


[Abstract] Objective To apply cardiac magnetic resonance feature-tracking (CMR-FT) to compare biventricular structural and functional differences between hypertensive (HTN) patients with and without type 2 diabetes mellitus (T2DM), to investigate the synergistic detrimental effect of T2DM on cardiac function in HTN patients, and to explore independent factors associated with concomitant T2DM in HTN patients.Materials and Methods A total of 172 HTN patients who underwent cardiac magnetic resonance (CMR) examination between September 2023 and September 2024 were retrospectively enrolled and divided into an HTN group (n = 97) and an HTN+T2DM group (n = 75) according to the presence or absence of T2DM. Conventional cardiac functional parameters and biventricular myocardial strain parameters were obtained using CVI42 software. Differences in clinical data, conventional cardiac function, and strain parameters were compared between the two groups, and the correlation between left and right ventricular strain was analyzed. Elastic net regularized regression and multivariable logistic regression were employed to identify independent factors associated with concomitant T2DM in HTN patients, and a combined clinical-imaging model was constructed to evaluate its discriminatory performance.Results After adjusting for confounders and correcting for multiple comparisons, compared with the HTN group, the HTN+T2DM group exhibited significant decreases in left ventricular end-diastolic volume index (LVEDVI), right ventricular stroke volume index (RVSVI), and right ventricular cardiac index (RVCI) (P < 0.05, adjusted q < 0.05). Additionally, the absolute values of left ventricular global longitudinal strain (LV-GLS), left ventricular basal global radial strain (LV-Basal-GRS), and left ventricular mid-ventricular global longitudinal strain (LV-Mid-GLS) were also significantly reduced relative to the HTN group (P < 0.05, adjusted q < 0.05). Multivariable logistic regression analysis revealed that N-terminal pro-B-type natriuretic peptide [OR = 1.013, 95% confidence interval (CI): 1.004 to 1.021], left ventricular end-systolic volume index (OR = 0.907, 95% CI: 0.839 to 0.981), right ventricular cardiac output (OR = 0.768, 95% CI: 0.593 to 0.993), LV-Basal-GRS (OR = 0.936, 95% CI: 0.881 to 0.995), and LV-Mid-GLS (OR = 1.148, 95% CI: 1.023 to 1.287) were independent factors associated with concomitant T2DM in HTN patients. The area under the receiver operating characteristic curve (AUC) of the combined clinical-imaging model based on the above indicators was 0.800 (95% CI: 0.735 to 0.865). The calibration curve and the Hosmer-Lemeshow test (χ2 = 10.134, P = 0.256) indicated good calibration of the model. Decision curve analysis demonstrated favorable clinical utility of the model.Conclusions CMR-FT can sensitively detect early impairment of left ventricular segmental strain and biventricular pump functional reserve in HTN patients with T2DM, even when ejection fraction is not significantly reduced. In conjunction with clinical indicators such as NT-proBNP, LVESVI, and RVCO, strain parameters derived from CMR-FT facilitate the assessment of the superimposed detrimental effect of T2DM on the heart in HTN patients, providing an imaging reference for early risk identification and precise intervention.
[Keywords] hypertension；type 2 diabetes mellitus；magnetic resonance imaging；cardiac magnetic resonance feature tracking；ventricular function；myocardial strain

WU Yongshun1   BAO Mengyuan1   ZHANG Linxin1   QI Haicheng1   XING Yan1, 2*  

1 Imaging Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China

2 Imaging Center, Xinjiang Cardiovascular and Cerebrovascular Hospital, Urumqi 830011, China

Corresponding author: XING Y, E-mail: xingyanzwb@sina.com

Conflicts of interest   None.

Received  2026-01-30
Accepted  2026-04-28
DOI: 10.12015/issn.1674-8034.2026.05.011
DOI:10.12015/issn.1674-8034.2026.05.011.

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