Association of imaging markers of myocardial fibrosis with metabolic and functional disturbances in early diabetic cardiomyopathy

Jellis, Christine, Wright, Jeremy, Kennedy, Dominic, Sacre, Julian, Jenkins, Carly, Haluska, Brian, Martin, Jennifer, Fenwick, John and Marwick, Thomas H. (2011) Association of imaging markers of myocardial fibrosis with metabolic and functional disturbances in early diabetic cardiomyopathy. Circulation: Cardiovascular Imaging, 4 6: 693-702. doi:10.1161/CIRCIMAGING.111.963587


Author Jellis, Christine
Wright, Jeremy
Kennedy, Dominic
Sacre, Julian
Jenkins, Carly
Haluska, Brian
Martin, Jennifer
Fenwick, John
Marwick, Thomas H.
Title Association of imaging markers of myocardial fibrosis with metabolic and functional disturbances in early diabetic cardiomyopathy
Journal name Circulation: Cardiovascular Imaging   Check publisher's open access policy
ISSN 1941-9651
1942-0080
Publication date 2011-11
Sub-type Article (original research)
DOI 10.1161/CIRCIMAGING.111.963587
Volume 4
Issue 6
Start page 693
End page 702
Total pages 10
Place of publication Baltimore, MD, U. S. A.
Publisher Lippincott Williams & Wilkins
Collection year 2012
Language eng
Formatted abstract
Background: Metabolic and vascular disturbances contribute to diabetic cardiomyopathy, but the role of interstitial fibrosis in early disease is unproven. We sought to assess the relationship between imaging markers of diffuse fibrosis and myocardial dysfunction and to link this to possible causes of early diabetic cardiomyopathy.

Methods and Results: Hemodynamic and metabolic data were measured in 67 subjects with type 2 diabetes mellitus (age 60±10 years) with no cardiac symptoms. Myocardial function was evaluated with standard echocardiography and myocardial deformation; ischemia was excluded by exercise echocardiography. Calibrated integrated backscatter was calculated from parasternal long-axis views. T1 mapping was performed after contrast with a modified Look-Locker technique using saturation recovery images. Amino-terminal propeptides of procollagens type I and III, as well as the carboxy-terminal propeptide of procollagen type I, were assayed to determine collagen turnover. Subjects with abnormal early diastolic tissue velocity (Em) had shorter postcontrast T1 values (P=0.042) and higher calibrated integrated backscatter (P=0.007). They were heavier (P=0.003) and had worse exercise capacity (P<0.001), lower insulin sensitivity (P=0.003), and blunted systolic tissue velocity (P=0.05). Postcontrast T1 was associated with diastolic dysfunction (Em r=0.28, P=0.020; E/Em r=−0.24, P=0.049), impaired exercise capacity (r=0.30, P=0.016), central adiposity (r=−0.26, P=0.046), blood pressure (systolic r=−0.30, P=0.012; diastolic r=−0.49, P<0.001), and insulin sensitivity (r=0.30, P=0.037). The association of T1 with E/Em (β=−0.31, P=0.017) was independent of blood pressure and metabolic disturbance. Amino-terminal propeptide of procollagens type III was linked to diastolic dysfunction (Em r=−0.32, P=0.008) and calibrated integrated backscatter (r=0.30, P=0.015) but not T1 values.

Conclusions: The association between myocardial diastolic dysfunction, postcontrast T1 values, and metabolic disturbance supports thatdiffuse myocardial fibrosis is an underlying contributor to early diabetic cardiomyopathy.
Keyword Diabetic cardiomyopathies
Fibrosis
Magnetic resonance
Diastolic dysfunction
Cardiac magnetic-resonance
Inversion-recovery molli
Heart-failure
Humans
Validation
Disease
Resolution
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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