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Eur Heart J Cardiovasc Imaging. 2014 Nov;15(11):1263-9. doi: 10.1093/ehjci/jeu121. Epub 2014 Jun 26.

Subclinical diastolic dysfunction in young adults with Type 2 diabetes mellitus: a multiparametric contrast-enhanced cardiovascular magnetic resonance pilot study assessing potential mechanisms.

Author information

1
Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
2
Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK.
3
The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Leicester, UK.
4
Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK.
5
Cardiovascular Research Department, Leeds General Infirmary, Leeds, West Yorkshire, UK.
6
CREATIS, Insa de Lyon, Lyon, France.
7
Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK gerry.mccann@uhl-tr.nhs.uk.

Abstract

AIMS:

To assess the cardiac, vascular, anthropometric, and biochemical determinants of subclinical diastolic dysfunction in younger adults with Type 2 diabetes mellitus (T2DM) using multiparametric contrast-enhanced cardiovascular magnetic resonance (CMR) imaging.

METHODS AND RESULTS:

Twenty adults <40 years with T2DM [mean age 31.8(6.6) years, T2DM duration 4.7(4.0) years] and 20 age and sex-matched controls [10 obese non-diabetic controls and 10 lean controls (LC)] were studied. Cardiac volumes and function, circumferential strain and peak early diastolic strain rate (PEDSR), myocardial perfusion reserve, aortic stiffness (distensibility, pulse-wave velocity), focal fibrosis on late gadolinium enhancement, and pre- and post-contrast T1 mapping for contrast agent partition coefficient (subset, n = 26) were determined by CMR. In the T2DM cohort, mean aortic distensibility correlated with PEDSR (r = 0.564, P = 0.023) and diabetes duration correlated inversely with PEDSR (r = -0.534, P = 0.015) on univariate analysis. There was a close association between PEDSR and peak systolic strain (r = -0.580, P = 0.007).

CONCLUSION:

In young adults with T2DM, diabetes duration and aortic distensibility were associated with diastolic dysfunction. Interventional studies are required to assess whether cardiac dysfunction can be reversed in this phenotype of patients.

KEYWORDS:

Aortic distensibility; Cardiac magnetic resonance imaging; Diabetes mellitus; Diabetic cardiomyopathies; Diabetic diastolic heart failure; Diastolic dysfunction diabetes mellitus

PMID:
24970723
DOI:
10.1093/ehjci/jeu121
[Indexed for MEDLINE]
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