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Relationship Between Left Ventricular Structural and Metabolic Remodeling in Type 2 Diabetes
Eylem Levelt1, Masliza Mahmod2, Stefan K Piechnik2
1Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, U.K.
Diabetes
|October 7, 2015
Summary
Cardiac steatosis, or fat in the heart, is linked to heart remodeling and dysfunction in type 2 diabetes. Reducing this fat may improve heart function in diabetic patients.
Area of Science:
- Cardiology
- Metabolic Diseases
- Medical Imaging
Background:
- Concentric left ventricular (LV) remodeling is a risk factor for cardiovascular events.
- Type 2 diabetes mellitus (T2DM) is often associated with concentric LV remodeling, but the underlying mechanisms are not fully understood.
- Cardiac steatosis and impaired myocardial energetics are potential contributors to LV remodeling in T2DM.
Purpose of the Study:
- To investigate the relationship between myocardial metabolic changes and LV remodeling in patients with T2DM.
- To assess the impact of cardiac steatosis and altered myocardial energetics on LV structure and function in T2DM.
Main Methods:
- Cardiovascular magnetic resonance imaging (CMR) was used to evaluate LV remodeling, function, and tissue characteristics.
- T1 mapping, 1H magnetic resonance spectroscopy (MRS) for myocardial triglyceride content (MTG), and 31P MRS for phosphocreatine-to-ATP ratio were employed.
- Comparison between 46 patients with T2DM and 20 matched control subjects.
Main Results:
- Patients with T2DM exhibited concentric LV remodeling, elevated MTG, and impaired myocardial energetics compared to controls.
- Cardiac steatosis independently predicted concentric remodeling and impaired systolic strain, indicating subtle contractile dysfunction.
- No significant difference in extracellular volume fraction was observed, ruling out fibrosis.
Conclusions:
- Cardiac steatosis may play a significant role in the development of concentric LV remodeling and contractile dysfunction in T2DM.
- Strategies targeting the reduction of MTG could be beneficial for reversing cardiac remodeling and improving heart function in diabetic patients.
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