Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarction

BackgroundExtracellular 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 validati...

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Main Authors: Lei Chen, Bowen Qiu, Xinjia Du, Jiahua Liu, Yuan Lu, Wenliang Che, Wensu Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1534236/full
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author Lei Chen
Lei Chen
Bowen Qiu
Xinjia Du
Jiahua Liu
Yuan Lu
Wenliang Che
Wensu Chen
author_facet Lei Chen
Lei Chen
Bowen Qiu
Xinjia Du
Jiahua Liu
Yuan Lu
Wenliang Che
Wensu Chen
author_sort Lei Chen
collection DOAJ
description BackgroundExtracellular 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).MethodsThis 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.ResultsThe 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.ConclusionsSynthetic 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.
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spelling doaj-art-d4d407b91ed44f77a84180ce1d38bf6a2025-08-20T03:24:08ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-06-011610.3389/fendo.2025.15342361534236Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarctionLei Chen0Lei Chen1Bowen Qiu2Xinjia Du3Jiahua Liu4Yuan Lu5Wenliang Che6Wensu Chen7Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaBackgroundExtracellular 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).MethodsThis 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.ResultsThe 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.ConclusionsSynthetic 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.https://www.frontiersin.org/articles/10.3389/fendo.2025.1534236/fullcardiac magnetic resonancesynthetic extracellular volumediabetesacute myocardial infarctionmajor adverse cardiac events
spellingShingle Lei Chen
Lei Chen
Bowen Qiu
Xinjia Du
Jiahua Liu
Yuan Lu
Wenliang Che
Wensu Chen
Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarction
Frontiers in Endocrinology
cardiac magnetic resonance
synthetic extracellular volume
diabetes
acute myocardial infarction
major adverse cardiac events
title Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarction
title_full Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarction
title_fullStr Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarction
title_full_unstemmed Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarction
title_short Establishment of a synthetic ECV model and its prognostic value in diabetes patients with acute myocardial infarction
title_sort establishment of a synthetic ecv model and its prognostic value in diabetes patients with acute myocardial infarction
topic cardiac magnetic resonance
synthetic extracellular volume
diabetes
acute myocardial infarction
major adverse cardiac events
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1534236/full
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