To evaluate published research on cardiac magnetic resonance (CMR) biomarkers for diagnosing and prognosticating specific cardiovascular complications in diabetes mellitus.
Key Findings:
Nineteen studies (n = 3,900+ patients) were included.
CMR revealed subclinical myocardial changes in diabetic patients, including higher extracellular volume fraction (ECV), reduced strain, impaired perfusion, and increased prevalence of late gadolinium enhancement (LGE).
Meta-analysis confirmed significantly elevated ECV (SMD = 0.838, p = 0.003), reduced myocardial perfusion reserve index (MPRI, SMD = 1.48, p = 0.033), and higher prevalence of LGE (SMD = 0.583, p < 0.001).
Native T1 showed no significant differences, with low between-study heterogeneity (I2 = 97.4%).
Interpretation:
CMR biomarkers provide insights into myocardial involvement in diabetes and may detect subclinical abnormalities, potentially influencing early intervention strategies.
Limitations:
Small number of studies included.
Cross-sectional nature of most studies.
Methodological diversity among studies, which may affect generalizability.
Conclusion:
Results should be viewed as preliminary; more large-scale, standardized, prospective trials are needed to confirm the contribution of CMR biomarkers to early detection and risk stratification.
