Increased left ventricular torsion in uncomplicated type 1 diabetic patients: the role of coronary microvascular function.
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.
Shivu
Ganesh Nallur
GN
Department of Cardiovascular Medicine, University of Birmingham, Birmingham, UK. drgani23@gmail.com
Abozguia
Khalid
K
Phan
Thanh Trung
TT
Ahmed
Ibrar
I
Weaver
Rebekah
R
Narendran
Parth
P
Stevens
Martin
M
Frenneaux
Michael
M
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