PMID- 26438611 OWN - NLM STAT- MEDLINE DCOM- 20160428 LR - 20220330 IS - 1939-327X (Electronic) IS - 0012-1797 (Print) IS - 0012-1797 (Linking) VI - 65 IP - 1 DP - 2016 Jan TI - Relationship Between Left Ventricular Structural and Metabolic Remodeling in Type 2 Diabetes. PG - 44-52 LID - 10.2337/db15-0627 [doi] AB - Concentric left ventricular (LV) remodeling is associated with adverse cardiovascular events and is frequently observed in patients with type 2 diabetes mellitus (T2DM). Despite this, the cause of concentric remodeling in diabetes per se is unclear, but it may be related to cardiac steatosis and impaired myocardial energetics. Thus, we investigated the relationship between myocardial metabolic changes and LV remodeling in T2DM. Forty-six nonhypertensive patients with T2DM and 20 matched control subjects underwent cardiovascular magnetic resonance to assess LV remodeling (LV mass-to-LV end diastolic volume ratio), function, tissue characterization before and after contrast using T1 mapping, and (1)H and (31)P magnetic resonance spectroscopy for myocardial triglyceride content (MTG) and phosphocreatine-to-ATP ratio, respectively. When compared with BMI- and blood pressure-matched control subjects, subjects with diabetes were associated with concentric LV remodeling, higher MTG, impaired myocardial energetics, and impaired systolic strain indicating a subtle contractile dysfunction. Importantly, cardiac steatosis independently predicted concentric remodeling and systolic strain. Extracellular volume fraction was unchanged, indicating the absence of fibrosis. In conclusion, cardiac steatosis may contribute to concentric remodeling and contractile dysfunction of the LV in diabetes. Because cardiac steatosis is modifiable, strategies aimed at reducing MTG may be beneficial in reversing concentric remodeling and improving contractile function in the hearts of patients with diabetes. CI - (c) 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. FAU - Levelt, Eylem AU - Levelt E AD - Centre 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. FAU - Mahmod, Masliza AU - Mahmod M AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. FAU - Piechnik, Stefan K AU - Piechnik SK AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. FAU - Ariga, Rina AU - Ariga R AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. FAU - Francis, Jane M AU - Francis JM AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. FAU - Rodgers, Christopher T AU - Rodgers CT AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. FAU - Clarke, William T AU - Clarke WT AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. FAU - Sabharwal, Nikant AU - Sabharwal N AD - Department of Cardiology, John Radcliffe Hospital, Oxford, U.K. FAU - Schneider, Jurgen E AU - Schneider JE AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. FAU - Karamitsos, Theodoros D AU - Karamitsos TD AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. First Department of Cardiology, Aristotle University, Thessaloniki, Greece. FAU - Clarke, Kieran AU - Clarke K AD - Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, U.K. FAU - Rider, Oliver J AU - Rider OJ AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. FAU - Neubauer, Stefan AU - Neubauer S AD - Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. stefan.neubauer@cardiov.ox.ac.uk. LA - eng GR - 098436/WT_/Wellcome Trust/United Kingdom GR - FS/11/50/29038/BHF_/British Heart Foundation/United Kingdom GR - FS/12/32/29559/BHF_/British Heart Foundation/United Kingdom GR - 098436/Z/12/Z/WT_/Wellcome Trust/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20151005 PL - United States TA - Diabetes JT - Diabetes JID - 0372763 RN - 0 (Phosphorus Isotopes) RN - 0 (Triglycerides) RN - 020IUV4N33 (Phosphocreatine) RN - 8L70Q75FXE (Adenosine Triphosphate) SB - IM MH - Adenosine Triphosphate/metabolism MH - Adipose Tissue/metabolism/pathology MH - Adult MH - Case-Control Studies MH - Coronary Angiography MH - Diabetes Mellitus, Type 2/complications/metabolism/pathology/*physiopathology MH - Echocardiography MH - Female MH - Heart/*physiopathology MH - Humans MH - Hypertrophy, Left Ventricular/complications/metabolism/pathology/*physiopathology MH - Magnetic Resonance Imaging, Cine MH - Magnetic Resonance Spectroscopy MH - Male MH - Middle Aged MH - Myocardium/metabolism/*pathology MH - Phosphocreatine/metabolism MH - Phosphorus Isotopes MH - Proton Magnetic Resonance Spectroscopy MH - Systole MH - Tomography, X-Ray Computed MH - Triglycerides/metabolism MH - *Ventricular Remodeling PMC - PMC4890658 MID - EMS68561 OID - NLM: EMS68561 EDAT- 2015/10/07 06:00 MHDA- 2016/04/29 06:00 PMCR- 2016/06/02 CRDT- 2015/10/07 06:00 PHST- 2015/05/12 00:00 [received] PHST- 2015/09/24 00:00 [accepted] PHST- 2015/10/07 06:00 [entrez] PHST- 2015/10/07 06:00 [pubmed] PHST- 2016/04/29 06:00 [medline] PHST- 2016/06/02 00:00 [pmc-release] AID - db15-0627 [pii] AID - 10.2337/db15-0627 [doi] PST - ppublish SO - Diabetes. 2016 Jan;65(1):44-52. doi: 10.2337/db15-0627. Epub 2015 Oct 5.