title: Subclinical diastolic dysfunction in young adults with Type 2 diabetes mellitus: a multiparametric contrast-enhanced cardiovascular magnetic resonance pilot study assessing potential mechanisms.
abstract: OBJECTIVE
  To assess the cardiac, vascular, anthropometric, and biochemical determinants of subclinical diastolic dysfunction in younger adults with Type 2 diabetes mellitus (T2DM) using multiparametric contrast-enhanced cardiovascular magnetic resonance (CMR) imaging.
  
  
  RESULTS
  Twenty adults <40 years with T2DM [mean age 31.8(6.6) years, T2DM duration 4.7(4.0) years] and 20 age and sex-matched controls [10 obese non-diabetic controls and 10 lean controls (LC)] were studied. Cardiac volumes and function, circumferential strain and peak early diastolic strain rate (PEDSR), myocardial perfusion reserve, aortic stiffness (distensibility, pulse-wave velocity), focal fibrosis on late gadolinium enhancement, and pre- and post-contrast T1 mapping for contrast agent partition coefficient (subset, n = 26) were determined by CMR. In the T2DM cohort, mean aortic distensibility correlated with PEDSR (r = 0.564, P = 0.023) and diabetes duration correlated inversely with PEDSR (r = -0.534, P = 0.015) on univariate analysis. There was a close association between PEDSR and peak systolic strain (r = -0.580, P = 0.007).
  
  
  CONCLUSIONS
  In young adults with T2DM, diabetes duration and aortic distensibility were associated with diastolic dysfunction. Interventional studies are required to assess whether cardiac dysfunction can be reversed in this phenotype of patients.
authors: Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
authors: Jamal Nasir
authors: JN
authors: Khan
authors: Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK.
authors: Emma Gwyn
authors: EG
authors: Wilmot
authors: The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Leicester, UK.
authors: Melanie
authors: M
authors: Leggate
authors: Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
authors: Anvesha
authors: A
authors: Singh
authors: Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK.
authors: Thomas
authors: T
authors: Yates
authors: The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Leicester, UK.
authors: Myra
authors: M
authors: Nimmo
authors: Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK.
authors: Kamlesh
authors: K
authors: Khunti
authors: Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
authors: Mark A
authors: MA
authors: Horsfield
authors: Cardiovascular Research Department, Leeds General Infirmary, Leeds, West Yorkshire, UK.
authors: John
authors: J
authors: Biglands
authors: CREATIS, Insa de Lyon, Lyon, France.
authors: Patrick
authors: P
authors: Clarysse
authors: CREATIS, Insa de Lyon, Lyon, France.
authors: Pierre
authors: P
authors: Croisille
authors: Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK.
authors: Melanie
authors: M
authors: Davies
authors: Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK gerry.mccann@uhl-tr.nhs.uk.
authors: Gerry Patrick
authors: GP
authors: McCann
mesh_terms: D000328:Adult; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood; D055424:Cardiac-Gated Imaging Techniques; D016022:Case-Control Studies; D003287:Contrast Media; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003971:Diastole; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D054144:Heart Failure, Diastolic / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D006334:Heart Function Tests; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010865:Pilot Projects; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D003287:Contrast Media
keywords: Aortic distensibility; Cardiac magnetic resonance imaging; Diabetes mellitus; Diabetic cardiomyopathies; Diabetic diastolic heart failure; Diastolic dysfunction diabetes mellitus