Fig. 24.1
Single frontal radiograph (left) shows cardiomegaly, pulmonary edema, and small effusions in the left costophrenic angle (1) and right minor fissure (2). A four-chamber image from an ultrasound (right) shows marked thickening of the interventricular septum and both the right and left ventricles
24.2.2 Echocardiography Findings
Ventricular hypertrophy is a common finding. Doppler imaging is used to evaluate left ventricular diastolic dysfunction based on diminished ventricular relaxation and elevated diastolic ventricular filling pressures. Echocardiography also can evaluate regional or global systolic ventricular hypokinesis.
24.2.3 MRI Findings
MRI often shows left ventricular hypertrophy. Imaging techniques are currently being investigated for detection of myocardial steatosis and increased extracellular matrix in the hearts of diabetic patients.
24.2.4 Cardiac Catheterization and Coronary Angiography
These methods are the gold standard for assessing diastolic dysfunction.
24.2.5 Imaging Recommendations
Echocardiography is a readily available screening modality for evaluation of ventricular hypertrophy and diastolic dysfunction
Cardiac catheterization is the gold standard for assessing diastolic dysfunction
MRI techniques are being investigated for evaluating myocardial steatosis and extracellular matrix
24.3 Differential Diagnosis
Hypertroph ic cardiomyopathy
Secondary left ventricular hypertrophy
Dilated cardiomyopathy
Congestive heart failure
24.4 Pathology
24.4.1 Frequency and Etiology
Cardiovascular complications are the leading cause of morbidity and mortality in diabetic patients, and diabetes mellitus is an independent risk factor for cardiovascular disease. Comorbidities associated with diabetes, such as hypertension and coronary artery disease, may amplify diabetes-related myocardial changes.
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