Project Details
Projekt
In vivo Characterisation of Myocardial Microstructure in Type 2 Diabetes Using Cardiac Diffusion Tensor and Intravoxel Incoherent Motion MRI
Applicant
Dr. Pia Leuders
Subject Area
Cardiology, Angiology
Term
since 2025
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 576223963
Type 2 diabetes mellitus (T2D) is a major risk factor for developing heart failure with preserved ejection fraction (HFpEF). The condition is driven by metabolic and inflammatory mechanisms that adversely affect cardiac structure and function. Subclinical myocardial changes, such as fibrosis, microvascular dysfunction, and cardiomyocyte disarray, often precede overt dysfunction but frequently go undetected by standard imaging (e.g., echocardiography, SSFP cine CMR). Early identification of these alterations is critical for accurate risk stratification and timely intervention. This project aims to detect early microstructural and microvascular myocardial changes in T2D using contrast-free cardiac diffusion tensor imaging (cDTI) and intravoxel incoherent motion (IVIM) magnetic resonance imaging. These advanced imaging techniques enable non-invasive assessment of myocardial architecture and perfusion, potentially identifying diabetic heart disease before functional impairment becomes clinically apparent. The study pursues three main objectives: (i) Establish reference values in healthy individuals: Assess age- and sex-specific variation in cDTI metrics (mean diffusivity, fractional anisotropy, helix angle, sheetlet orientation) and IVIM parameters (diffusion, pseudo-diffusion, perfusion fraction). (ii) Compare T2D patients with healthy controls: Quantify diabetes-related alterations in myocardial structure and perfusion; evaluate the impact of glycemic control and insulin resistance on imaging biomarkers. (iii) Link microstructural changes to early diastolic dysfunction: Correlate imaging metrics with diastolic function (via echocardiography, strain analysis, and stress testing) to detect early functional impairment. A cross-sectional observational study will recruit adults with and without T2D in Switzerland. All participants will undergo advanced CMR (cDTI and IVIM), echocardiography, metabolic profiling, and optional stress testing. Data analysis will focus on identifying non-invasive imaging biomarkers of subclinical myocardial alterations. The applicant brings strong expertise in cardiovascular MRI and cardiometabolic phenotyping. The project builds on prior work from large-scale trials (SYSTEMI, NCT03539133; PHaRAo, NCT05603520) conducted at Heinrich Heine University Düsseldorf, and is supported by collaborations with the Institute for Biomedical Engineering, ETH Zurich (Prof. Kozerke) and the University Hospital Zurich (Prof. Manka, Cardiovascular MRI). The host institution in Zurich provides excellent infrastructure and access to cohort studies (e.g., SwissHeart Study), offering an ideal environment for successful project implementation. By integrating cDTI and IVIM into cardiometabolic research, the project seeks to establish novel imaging biomarkers that support early risk stratification and future targeted preventive strategies in T2D.
DFG Programme
WBP Fellowship
International Connection
Switzerland
