MRI evaluation of end-organ damage in diabetes and hypertension

Abstract

Our studies have shown MRI assessed aortic stiffness being an integrated marker of cardiac function, cerebral small vessel disease and atrophy, as well as of renal function in type1 diabetes mellitus patients. Aortic stiffness already in normal range is related to end-organ damage in type1 diabetes mellitus, suggesting increased organ-susceptibility for vascular alterations in diabetes mellitus. Structural changes in the brain as a manifestation of end-organ damage has shown to be clinical relevant to elderly with diabetes mellitus predicting accelerated cognitive decline. Hypertension is a major contributor to increased aortic stiffness. There is clear effect of aortic stiffness on cardiac and cerebral end-organ damage in hypertensive patients, which is different from type1 diabetes mellitus. The results of our cross-sectional studies suggest that MRI assessment of aortic pulse wave velocity could function as a marker or risk factor for generalized vascular disease and end-organ damage that might potentially be treated. Our findings may therefore have implications for cardiovascular risk stratification and optimization of therapy in diabetes mellitus and hypertensive patients beyond classical risk factors. Finally, this thesis describes the technical implementation and benefits of right coronary artery MRA at high field 7T. This is a promising step towards improved MRI detection of coronary artery disease.