Myocardial steatosis and biventricular strain and strain rate imaging in patients with type 2 diabetes mellitus.
BACKGROUND
Magnetic resonance spectroscopy can quantify myocardial triglyceride content in type 2 diabetic patients. Its relation to alterations in left (LV) and right (RV) ventricular myocardial functions is unknown.


RESULTS
A total of 42 men with type 2 diabetes mellitus were recruited. Exclusion criteria included hemoglobin A(1c) >8.5, known cardiovascular disease, diabetes-related complications, or blood pressure >150/85 mm Hg. Myocardial ischemia was excluded by a negative dobutamine stress test. LV and RV volumes and ejection fraction were quantified by magnetic resonance imaging. LV global longitudinal and RV free wall longitudinal strain, systolic strain rate, and diastolic strain rate were quantified by echocardiographic speckle tracking analyses. Myocardial triglyceride content was quantified by magnetic resonance spectroscopy and dichotomized on the basis of the median value of 0.76. The median age was 59 years (25th and 75th percentiles, 54 and 62 years). Median diabetes diagnosis duration was 4 years, and median glycohemoglobin level was 6.2 (25th and 75th percentiles, 5.9 and 6.8). There were no differences in LV and RV end-diastolic and end-systolic volume indexes and ejection fraction between patients with high (≥0.76) and those with low (<0.76) myocardial triglyceride content. However, patients with high myocardial triglyceride content had greater impairment of LV and RV myocardial strain and strain rate. The myocardial triglyceride content was an independent correlate of LV and RV longitudinal strain, systolic strain rate, and diastolic strain rate.


CONCLUSIONS
High myocardial triglyceride content is associated with more pronounced impairment of LV and RV functions in men with uncomplicated type 2 diabetes mellitus.
Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
Arnold C T
AC
Ng
Victoria
V
Delgado
Matteo
M
Bertini
Rutger W
RW
van der Meer
Luuk J
LJ
Rijzewijk
See
S
Hooi Ewe
Hans-Marc
HM
Siebelink
Johannes W A
JW
Smit
Michaela
M
Diamant
Johannes A
JA
Romijn
Albert
A
de Roos
Dominic Y
DY
Leung
Hildo J
HJ
Lamb
Jeroen J
JJ
Bax
D009202:Cardiomyopathies / Q000150:complications / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D014280:Triglycerides / Q000032:analysis / Q000378:metabolism*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*
D014280:Triglycerides