Single-center Clinical Study of Early Diagnosis of Diabetic Cardiomyopathy With FLIM
Single-center Clinical Study of Early Diagnosis of Diabetic Cardiomyopathy With FLIM
Diabetic Cardiomyopathy (DCM) is disease of myocardial structure and function which is
 independent of hypertension, coronary heart disease, heart valve abnormalities, and other
 types of heart disease. DCM affects approximately 12% of diabetics and also appeared in some
 patients with well-controlled blood glucose. There is no specific and effective diagnostic
 method of DCM currently. Since it is well known that the dysfunction of myocardial metabolism
 caused by hyperglycemia and insulin resistance induces DCM, the method of evaluation of the
 metabolism will assist the diagnosis of DCM.

 Nicotinamide adenine dinucleotide (phosphate) (NAD(P)H) is one of important coenzymes
 involved in biological metabolism. Fluorescence lifetime microscopy (FLIM) can detect the
 metabolic status based on the fluorescence characteristics of NAD(P)H. Previous studies have
 reported that NAD(P)H fluorescence lifetime can be used to assess the metabolic status of
 living cardiomyocytes cultured in vitro, and metabolism changes related to myocardial
 infarction and heart failure in rats. the investigators detected the metabolic status by
 label-free FLIM on the myocardial tissues and blood plasma in a rat model of type 2 diabetic
 cardiomyopathy, and found FLIM could provide valuable information about the myocardial
 metabolism by detecting the NAD(P)H fluorescence lifetime of blood plasma.

 Recently, The investigators have explored the method of the FLIM in clinical study. The
 investigators used FLIM to compare the NAD(P)H fluorescence lifetime of blood plasma in
 healthy participants, type 2 diabetic patients with normal diastolic function and with
 diastolic dysfunction. The results showed that the NAD(P)H fluorescence life parameter of a2
 was lower in type 2 diabetic patients with diastolic dysfunction (30.5±2.7%) than in healthy
 participants (41.5±4.8%) and type 2 diabetic patients with normal diastolic function
 (37.8±3.7%). Therefore, The investigators propose FLIM can provide valuable information about
 the myocardial metabolism, and it can be used as a non-invasive, label-free, and rapid
 screening method of diagnosis of DCM.

 In this study, the investigators will recruit 243 patients with type 2 diabetes and divide
 them into two groups: normal diastolic function group (DM Group) and diastolic dysfunction
 group (DCM Group), based on the symptoms, laboratory examination and echocardiographic
 results. Then FLIM will be applied to detect the NAD(P)H fluorescence characteristics of
 venous blood of all patients. After that, the correlation between the parameters of diastolic
 function (E peak, E/E' ratio, left atrial volume, NT-proBNP) and the parameters of metabolism
 status (NAD(P)H fluorescence life parameter of a2 and the ratio of bound state/free state
 NAD(P)H) will be analyzed. This study will verify FLIM is helpful to diagnose DCM.
Inclusion Criteria:

 1. Male or female, aged 18-80 years old;

 2. Echocardiography showed that the cardiac structure was normal and the left ventricular
 ejection fraction was more than 50%;

 3. patients with type 2 diabetes mellitus;

 4. Body mass index (BMI) was 20-25 kg / m2 in male and 19-24 kg / m2 in female;

 5. No other drugs except hypoglycemic drugs were taken in one month;

 6. Sign informed consent form before entering this study.

 Exclusion Criteria:

 1. Patients with type 1 diabetes mellitus;

 2. Patients with diabetic ketoacidosis in the past;

 3. Patients with coronary heart disease or with myocardial ischemia indicated by ECG;

 4. EGFR < 60ml / min / 1.73m2 in recent one month;

 5. Chronic liver disease, or the levels of alanine aminotransferase and glutamic
 oxaloacetic transaminase were more than 3 times of the upper limit of the normal
 before enrollment;

 6. Abnormal thyroid function;

 7. Abnormal tumor index;

 8. Dyslipidemia;

 9. Pregnant and lactating women;

 10. Allergy to contrast media.