- Oral presentation
- Open Access
Detection and potential mechanisms of subclinical left ventricular dysfunction in asymptomatic young adults with Type-2 Diabetes
© Khan et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Late Gadolinium Enhancement
- Obese Control
- Aortic Distensibility
- Myocardial Perfusion Reserve
- Diffuse Myocardial Fibrosis
There is an epidemic of obesity and Type-2 Diabetes Mellitus (T2DM) in the developed world. Subclinical diastolic dysfunction in diabetes is associated with the development of overt heart failure. Although diabetic cardiomyopathy is well documented in older adults with T2DM there are scarce data on younger adults and no published CMR data. We aimed to assess the prevalence and potential mechanisms of subclinical left ventricular (LV) dysfunction in young T2DM adults compared to healthy lean (LC) and obese controls (OC).
40 subjects (20 T2DM [mean T2DM duration 4.7±4.0years], 10 OC, 10 LC) underwent CMR assessment on a Siemens Avanto 1.5T system. LV function and volumes were assessed using SSFP. Circumferential strain was assessed using a high temporal-resolution CSPAMM tagging sequence at 3 slices (basal, mid-cavity, apical). Rest and stress perfusion was assessed quantitatively for perfusion defects and by calculating myocardial perfusion reserve (MPR) using model independent deconvolution at 3 slices. In a subset of the cohort (11 T2DM, 9 OC and 6 LC) T1 mapping with heart-rate correction in a single short-axis slice was performed using a Modified Look-Locker Inversion Recovery (MOLLI) sequence before and 16 minutes post administration of 0.2mmol/kg of Gadovist. Aortic distensibility was assessed on high temporal-resolution gradient echo images.
CMR and anthropometric data for the 3 study groups (OC, LC, T2DM)
Lean control (LC) (n=10)
Obese control (OC) (n=10)
Type-2 diabetes (T2DM) (n=20)
T2DM v LC (p)*
T2DM v OC (p)*
Sex (no. M:F)
PEDSR (1/s) (n for analysis)
Partition Coefficient (n for analysis)
This study does not suggest that obesity, ischaemia, microvascular dysfunction or diffuse myocardial fibrosis are the main mechanisms contributing to subclinical diastolic dysfunction in young adults with T2DM. Duration of T2DM was strongly associated with diastolic dysfunction. Young onset T2DM is likely to result in a very high lifetime risk of cardiovascular events and heart failure.
NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity BRU at the University Hospitals of Leicester NHS Trust, University of Leicester and Loughborough University, the NIHR Leicester Cardiovascular Biomedical Research Unit and the NIHR Collaboration for Leadership in Applied Health Research and Care - Leicestershire, Northamptonshire and Rutland (NIHR CLAHRC for LNR).
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