Abstract
BackgroundMetabolic syndrome (MetS) is a cluster of metabolic abnormalities that collectively cause an increased risk of type 2 diabetes mellitus (T2DM) and nonatherosclerotic cardiovascular disease. This study aimed to evaluate the role of myocardial steatosis in T2DM patients with or without MetS, as well as the relationship between subclinical left ventricular (LV) myocardial dysfunction and myocardial steatosis.Methods and materialsWe recruited 53 T2DM patients and 20 healthy controls underwent cardiac magnetic resonance examination. All T2DM patients were subdivide into two group: MetS group and non-MetS. LV deformation, perfusion parameters and myocardial triglyceride (TG) content were measured and compared among these three groups. Pearson’s and Spearman analysis were performed to investigate the correlation between LV cardiac parameters and myocardial steatosis. The receiver operating characteristic curve (ROC) was performed to illustrate the relationship between myocardial steatosis and LV subclinical myocardial dysfunction.ResultsAn increase in myocardial TG content was found in the MetS group compared with that in the other groups (MetS vs. non-MetS: 1.54 ± 0.63% vs. 1.16 ± 0.45%; MetS vs. normal: 1.54 ± 0.63% vs. 0.61 ± 0.22%; all p < 0.001). Furthermore, reduced LV deformation [reduced longitudinal and radial peak strain (PS); all p < 0.017] and microvascular dysfunction [increased time to maximum signal intensity (TTM) and reduced Upslope; all p < 0.017)] was found in the MetS group. Myocardial TG content was positively associated with MetS (r = 0.314, p < 0.001), and it was independently associated with TTM (β = 0.441, p < 0.001) and LV longitudinal PS (β = 0.323, p = 0.021). ROC analysis exhibited that myocardial TG content might predict the risk of decreased LV longitudinal myocardial deformation (AUC = 0.74) and perfusion function (AUC = 0.71).ConclusionMyocardial TG content increased in T2DM patients with concurrent MetS. Myocardial steatosis was positively associated with decreased myocardial deformation and perfusion dysfunction, which may be an indicator for predicting diabetic cardiomyopathy.
Highlights
Current literature outlines that the excessive accumulation of lipid in cardiomyocytes is bound to facilitate myocardial lipotoxic injury, which, plays an important role in the development of diabeticGao et al Cardiovasc Diabetol (2020) 19:70 cardiomyopathy [1,2,3]
Myocardial TG content was positively associated with Metabolic syndrome (MetS) (r = 0.314, p < 0.001), and it was indepen‐ dently associated with time to maximum signal intensity (TTM) (β = 0.441, p < 0.001) and left ventricular (LV) longitudinal peak strain (PS) (β = 0.323, p = 0.021)
Myocardial steatosis was positively associated with decreased myocardial deformation and perfusion dysfunction, which may be an indicator for predicting diabetic cardiomyopathy
Summary
Current literature outlines that the excessive accumulation of lipid in cardiomyocytes (myocardial steatosis) is bound to facilitate myocardial lipotoxic injury, which, plays an important role in the development of diabeticGao et al Cardiovasc Diabetol (2020) 19:70 cardiomyopathy [1,2,3]. Metabolic syndrome (MetS) is a cluster of risk factors such as central obesity, hyperglycemia, dyslipidemia and hypertension that collectively increase the risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease [4]. Chronic inflammation caused by central obesity has been described as an essential factor in the occurrence and development of MetS, and the transition of MetS to cardiovascular disease [6]. Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that collectively cause an increased risk of type 2 diabetes mellitus (T2DM) and nonatherosclerotic cardiovascular disease. This study aimed to evaluate the role of myocardial steatosis in T2DM patients with or without MetS, as well as the relationship between subclinical left ventricular (LV) myocardial dysfunction and myocardial steatosis
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