title: Subclinical coronary and aortic atherosclerosis detected by magnetic resonance imaging in type 1 diabetes with and without diabetic nephropathy.
abstract: BACKGROUND
  Patients with type 1 diabetes and nephropathy maintain an excess cardiovascular mortality compared with diabetic patients with normoalbuminuria. We sought to evaluate coronary and aortic atherosclerosis in a cohort of asymptomatic type 1 diabetic patients with and without diabetic nephropathy using cardiovascular magnetic resonance imaging.
  
  
  RESULTS
  In a cross-sectional study, 136 subjects with long-standing type 1 diabetes without symptoms or history of cardiovascular disease, including 63 patients (46%) with nephropathy and 73 patients with normoalbuminuria, underwent cardiovascular magnetic resonance imaging. All subjects underwent cardiac exercise testing and noninvasive tests for peripheral artery disease and autonomic neuropathy. Coronary artery stenoses were identified in 10% of subjects with nephropathy (versus 0% with normoalbuminuria; P=0.007). Coronary plaque burden, expressed as right coronary artery mean wall thickness (1.7+/-0.3 versus 1.3+/-0.2 mm; P<0.001) and maximum right coronary artery wall thickness (2.2+/-0.5 versus 1.6+/-0.3 mm; P<0.001), was greater in subjects with nephropathy. The prevalence of thoracic (3% versus 0%; P=0.28) and abdominal aortic plaque (22% versus 16%; P=0.7) was similar in both groups. Subjects with and without abdominal aortic plaques had similar coronary plaque burden.
  
  
  CONCLUSIONS
  In asymptomatic type 1 diabetes, cardiovascular magnetic resonance imaging reveals greater coronary plaque burden in subjects with nephropathy compared with those with normoalbuminuria.
authors.affiliation: Department of Cardiology, Skejby Hospital, Brendstrupgaardsvej, 8200 Aarhus N, Denmark. yong.kim@ki.au.dk
authors.forename: Won Yong
authors.initials: WY
authors.lastname: Kim
authors.forename: Anne Sofie
authors.initials: AS
authors.lastname: Astrup
authors.forename: Matthias
authors.initials: M
authors.lastname: Stuber
authors.forename: Lise
authors.initials: L
authors.lastname: Tarnow
authors.forename: Erling
authors.initials: E
authors.lastname: Falk
authors.forename: René M
authors.initials: RM
authors.lastname: Botnar
authors.forename: Cheryl
authors.initials: C
authors.lastname: Simonsen
authors.forename: Lotte
authors.initials: L
authors.lastname: Pietraszek
authors.forename: Peter R
authors.initials: PR
authors.lastname: Hansen
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Manning
authors.forename: Niels T
authors.initials: NT
authors.lastname: Andersen
authors.forename: Hans-Henrik
authors.initials: HH
authors.lastname: Parving
mesh_terms: D000328:Adult; D001012:Aorta, Abdominal / Q000473:pathology; D001013:Aorta, Thoracic / Q000473:pathology; D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis*; D003928:Diabetic Nephropathies / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged