title: Short-term flexibility of myocardial triglycerides and diastolic function in patients with type 2 diabetes mellitus.
abstract: Short-term caloric restriction increases plasma levels of nonesterified fatty acids (NEFAs) and is associated with increased myocardial triglyceride (TG) content and decreased myocardial function in healthy subjects. Whether this flexibility of myocardial TG stores and myocardial function is also present in patients with type 2 diabetes mellitus (T2DM) is yet unknown. Myocardial TG content and left ventricular (LV) ratio between the early (E) and atrial (A) diastolic filling phase (E/A) were determined using magnetic resonance (MR) spectroscopy and MR imaging, respectively, before and after a 3-day very low-calorie diet (VLCD) in 11 patients with T2DM. In addition, we studied patients after a 3-day VLCD combined with the antilipolytic drug acipimox. The VLCD induced myocardial TG accumulation [from 0.66 +/- 0.09% (mean +/- SE, baseline) to 0.98 +/- 0.16%, P = 0.028] and a decrease in E/A ratio [from 1.00 +/- 0.05 (baseline) to 0.90 +/- 0.06, P = 0.002]. This was associated with increased plasma NEFA levels (from 0.57 +/- 0.08 mmol/l at baseline to 0.92 +/- 0.12, P = 0.019). After the VLCD with acipimox, myocardial TG content, diastolic function, and plasma NEFA levels were similar to baseline values. In conclusion, in patients with T2DM, a VLCD increases myocardial TG content and is associated with a decrease in LV diastolic function. These effects were not observed when a VLCD was combined with acipimox, illustrating the physiological flexibility of myocardial TG stores and myocardial function in patients with T2DM.
authors.affiliation: Depts. of Endocrinology & Metabolism and Radiology ,Leiden University Medical Center, 2300 RC Leiden, the Netherlands. S.Hammer@LUMC.nl
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Hammer
authors.forename: Rutger W
authors.initials: RW
authors.lastname: van der Meer
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: Hans H
authors.initials: HH
authors.lastname: de Boer
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D031204:Caloric Restriction; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000503:physiopathology*; D003971:Diastole; D005230:Fatty Acids, Nonesterified / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D011719:Pyrazines / Q000494:pharmacology; D014280:Triglycerides / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D005230:Fatty Acids, Nonesterified; D006442:Glycated Hemoglobin; D000960:Hypolipidemic Agents; D011719:Pyrazines; D014280:Triglycerides; C027696:acipimox