Diabetic Cardiomyopathy and Cardiac MRI (DiCOM Study)

Years funded:
2019

Diabetes is now at epidemic proportions in developed countries.

The chance of a patient developing “heart failure”, a failure of the heart to meet the demands of the body, is increased two to threefold by diabetes (1, 2). It is the leading cause of death in patients with Type 2 Diabetes (3-5). The majority of heart dysfunction seen is due to abnormalities in the heart muscle itself (6) - known as “Diabetic Cardiomyopathy” (DiCM). The “hallmark” of this type of heart condition is the abnormal presence of fibrosis which impairs heart function. It affects at least 12% of all patients with diabetes and 22% of those over 64 years. (7) 

Cardiac MRI (cMRI) is a method that uses a strong magnetic field to image the heart. Advances in this technology, called T1 Mapping, has enabled the detection of abnormalities of DiCM normally only seen on autopsy. cMRI allows heart muscle characterisation without the need for invasive procedures. It is effectively a magnifying glass into the heart muscle from outside the body. Preliminary studies using cMRI to detect fibrosis and other changes have shown that specific markers seen with cMRI in diabetic patients are associated with increased death and hospitalisations for heart failure.(8) 

There is still a paucity of data as to why, when and what predisposes patients to DiCM, and extremely limited research on treatment options.

We seek to test cMRI - T1 Mapping in an Australia diabetes population, identify predictors of DiCM AND establish a cMRI program that will test and monitor DiCM treatment regimes.

The DiCOM Study will provide the following:

  1. Pilot data on the presence of fibrosis and evidence of DiCM in a cohort of patients – to be used for further NHMRC Grant applications
  2. Identification of possible imaging markers and predictors of DiCM 
  3. Development of a cMRI platform to improve diagnosis and management of DiCM and serve as a centre-point for future funded clinical intervention trials.

Researcher Profile

Associate Professor Raj Puranik

Institute: University of Sydney
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