title: Left ventricular diastolic function in type 2 diabetes mellitus is associated with myocardial triglyceride content but not with impaired myocardial perfusion reserve.
abstract: OBJECTIVE
  To study myocardial perfusion reserve and myocellular metabolic alterations indicated by triglyceride content as possible causes of diastolic dysfunction in patients with type 2 diabetes mellitus, preserved systolic function, and without clinically evident coronary artery disease.
  
  
  METHODS
  Patients with type 2 diabetes mellitus (n = 42) underwent cardiac magnetic resonance (CMR) for quantification of 1) myocardial contractility by strain-encoded MR (SENC); 2) myocardial triglyceride content by proton magnetic resonance spectroscopy ((1) H-MRS); and 3) myocardial perfusion reserve during pharmacologic hyperemia. Age-matched healthy volunteers (n = 16) also underwent CMR to acquire normal values for myocardial strain and perfusion reserve.
  
  
  RESULTS
  Stress CMR procedures were successfully performed in all subjects, and no regional inducible perfusion defects were observed in type 2 diabetes mellitus patients. Diastolic strain rate and myocardial perfusion reserve were significantly impaired in patients with type 2 diabetes mellitus compared to control subjects (P < 0.001 for both). Interestingly, impaired diastolic function in type 2 diabetes mellitus was not associated with impaired myocardial perfusion reserve (r = 0.12, P = NS). Conversely a significant association was observed between diastolic dysfunction and myocardial triglyceride content (r = -0.71, P < 0.001), which proved to be independent of age, gender, diabetes duration, blood pressure, and fasting blood glucose.
  
  
  CONCLUSIONS
  Myocardial steatosis may represent an early marker of diabetic heart disease, triggering subclinical myocardial dysfunction irrespective of myocardial perfusion reserve.
authors: University of Heidelberg, Department of Cardiology, Heidelberg, Germany. gkorosoglou@hotmail.com
authors: Grigorios
authors: G
authors: Korosoglou
authors: Per M
authors: PM
authors: Humpert
authors: Johannes
authors: J
authors: Ahrens
authors: Dimitrios
authors: D
authors: Oikonomou
authors: Nael F
authors: NF
authors: Osman
authors: Gitsios
authors: G
authors: Gitsioudis
authors: Sebastian J
authors: SJ
authors: Buss
authors: Henning
authors: H
authors: Steen
authors: Bernhardt
authors: B
authors: Schnackenburg
authors: Angelika
authors: A
authors: Bierhaus
authors: Peter P
authors: PP
authors: Nawroth
authors: Hugo A
authors: HA
authors: Katus
mesh_terms: D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000378:metabolism*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology*
chemical_list: D014280:Triglycerides