Abstract

Diabetes can elicit direct deleterious effects on the myocardium, independent of coronary artery disease or hypertension. These cardiac disturbances are termed diabetic cardiomyopathy showing increased risk of heart failure with or without reduced ejection fraction. Presently, there is no specific treatment for this type of cardiomyopathy and in the case of type I diabetes, it may start in early childhood independent of glycemic control. We hypothesized that alterations in isolated myocyte contractility and cardiac function are present in the early stages of experimental diabetes in rats before overt changes in myocardium structure occur. Diabetes was induced by single-dose injection of streptozotocin (STZ) in rats with data collected from control and diabetic animals 3 weeks after injection. Left ventricle myocyte contractility was measured by single-cell length variation under electrical stimulation. Cardiac function and morphology were studied by high-resolution echocardiography with pulsed-wave tissue Doppler imaging (TDI) measurements and three-lead surface electrocardiogram. Triglycerides, cholesterol and liver enzyme levels were measured from plasma samples obtained from both groups. Myocardial collagen content and perivascular fibrosis of atria and ventricle were studied by histological analysis after picrosirius red staining. Diabetes resulted in altered contractility of isolated cardiac myocytes with increased contraction and relaxation time intervals. Echocardiography showed left atrium dilation, increased end-diastolic LV and posterior wall thickness, with reduced longitudinal systolic peak velocity (S’) of the septum mitral annulus at the apical four-chamber view obtained by TDI. Triglycerides, aspartate aminotransferase and alkaline phosphatase were elevated in diabetic animals. Intertitial collagen content was higher in atria of both groups and did not differ among control and diabetic animals. Perivascular intramyocardial arterioles collagen did not differ between groups. These results suggest that alterations in cardiac function are present in the early phase in this model of diabetes type 1 and occur before overt changes in myocardium structure appear as evaluated by intersticial collagen deposition and perivascular fibrosis of intramyocardial arterioles.

Highlights

  • Diabetes mellitus (DM) is among the leading causes of death globally and is considered a major risk factor for cardiovascular disease

  • Diabetic cardiomyopathy is characterized by structural, metabolic and functional changes in the myocardium in the absence of other cardiac risk factors, such as ischemia, hypertension or other pathophysiological processes that may justify heart failure

  • diabetic cardiomyopathy (DCM) is usually asymptomatic in the early stages of its evolution

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Summary

Introduction

Diabetes mellitus (DM) is among the leading causes of death globally and is considered a major risk factor for cardiovascular disease. DM is a major risk factor for cardiovascular disease [2, 3] and patients with DM may suffer from myocardial disease unrelated to other cardiovascular conditions, called diabetic cardiomyopathy (DCM) [4]. DCM results from complex interactions between metabolic abnormalities arising from hyperglycemia and insulin resistance that accompany DM as well other signaling and cellular alterations [5,6,7]. Passive stiffening of permeabilized cardiomyocyte has been shown to occur in DM, being related to titin phosphorylation and insulin signaling [10]

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