title: Increased left ventricular torsion in uncomplicated type 1 diabetic patients: the role of coronary microvascular function.
abstract: OBJECTIVE
  We used speckle tracking echocardiography to study the early changes in left ventricular (LV) torsion in young patients with uncomplicated type 1 diabetes and stress magnetic resonance imaging (MRI) to assess its interrelationships with coronary microangiopathy.
  
  
  METHODS
  We recruited 33 asymptomatic subjects with type 1 diabetes and 32 age-matched healthy control subjects. All subjects underwent echocardiograms. Stress MRIs were performed in 30 subjects (8 healthy control subjects) to compute myocardial perfusion reserve index (MPRI).
  
  
  RESULTS
  A significant increase in LV torsion (2 +/- 0.7 vs. 1.4 +/- 0.7 degrees /cm, P < 0.05) was identified in longer-term and retinopathy-positive type 1 diabetic subjects (1.9 +/- 0.7 vs. 1.4 +/- 0.7 degrees /cm, P < 0.05) as compared with the healthy control subjects. The MPRI was independently associated with increased LV torsion.
  
  
  CONCLUSIONS
  We demonstrate that LV torsion is increased in young patients with uncomplicated type 1 diabetes and that coronary microvascular disease may play a key pathophysiological role in the development of increased LV torsion.
authors.affiliation: Department of Cardiovascular Medicine, University of Birmingham, Birmingham, UK. drgani23@gmail.com
authors.forename: Ganesh Nallur
authors.initials: GN
authors.lastname: Shivu
authors.forename: Khalid
authors.initials: K
authors.lastname: Abozguia
authors.forename: Thanh Trung
authors.initials: TT
authors.lastname: Phan
authors.forename: Ibrar
authors.initials: I
authors.lastname: Ahmed
authors.forename: Rebekah
authors.initials: R
authors.lastname: Weaver
authors.forename: Parth
authors.initials: P
authors.lastname: Narendran
authors.forename: Martin
authors.initials: M
authors.lastname: Stevens
authors.forename: Michael
authors.initials: M
authors.lastname: Frenneaux
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003326:Coronary Circulation / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult