title: Effects of glycaemic variability on cardiac remodelling after reperfused myocardial infarction: Evaluation of streptozotocin-induced diabetic Wistar rats using cardiac magnetic resonance imaging.
abstract: OBJECTIVE
  In addition to hyperglycaemia, glycaemic variability seems to be associated with poor outcomes after acute myocardial infarction. This study explored the impact of glycaemic variability in diabetic Wistar rats subjected to myocardial ischaemia/reperfusion.
  
  
  METHODS
  Animals with streptozotocin-induced diabetes received insulin either to maintain stable hyperglycaemia (Dh group) or to generate glycaemic variability (Dv). After experimental myocardial ischaemia/reperfusion was surgically induced, 7T cardiac magnetic resonance imaging (CMR) was performed at weeks 1 (w1) and 3 (w3).
  
  
  RESULTS
  Twenty-six rats were randomized [sham group (S): n=5; control group (C): n=7; Dh group: n=6; and Dv group: n=8]. The mean amplitude of glucose reflecting glycaemic variability was higher in the Dv than in the Dh group (9.1±2.7mmol/L vs 5.9±1.9mmol/L; P<0.05). CMR assessment at w3 revealed ventricular enlargement in both Dh and Dv groups compared with the C and S groups (end-diastolic volume: 1.60±0.22 and 1.36±0.30mL/kg compared with 1.11±0.13 and 0.87±0.11mL/kg, respectively; P<0.05). Circumferential strain was altered between w1 and w3 in the remote area only in the Dv group, resulting in a lower value in this group than in the S, C and Dh groups (-0.11±0.01 vs -0.17±0.05, -0.15±0.03 and -0.16±0.03, respectively; P<0.05). In addition, at w3, oedema was also higher in the remote area in the Dv than in the C group (18.3±4.9ms vs 14.5±1.7ms, respectively; P<0.05).
  
  
  CONCLUSIONS
  In the context of experimental myocardial ischaemia/reperfusion, our results suggest that glycaemic variability might have a potentially deleterious impact on myocardial outcomes beyond the classical glucose metrics.
authors.affiliation: Diabetes Care Unit, Caen University Hospital, Caen, France; EA4650 Normandie université, GIP Cyceron, 14000 Caen, France. Electronic address: dr.michaeljoubert@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Joubert
authors.affiliation: Diabetes Care Unit, Caen University Hospital, Caen, France; EA4650 Normandie université, GIP Cyceron, 14000 Caen, France. Electronic address: hardouin-j@chu-caen.fr.
authors.forename: J
authors.initials: J
authors.lastname: Hardouin
authors.affiliation: Cardiology Unit, Caen University Hospital, 14033 Caen, France; EA4650 Normandie université, GIP Cyceron, 14000 Caen, France. Electronic address: legallois-da@chu-caen.fr.
authors.forename: D
authors.initials: D
authors.lastname: Legallois
authors.affiliation: Cardiology Unit, Caen University Hospital, 14033 Caen, France; EA4650 Normandie université, GIP Cyceron, 14000 Caen, France. Electronic address: blanchart-k@chu-caen.fr.
authors.forename: K
authors.initials: K
authors.lastname: Blanchart
authors.affiliation: CMABIO-HIQ Facility, SF4206 ICORE, IBFA, University of Caen, 14000 Caen, France. Electronic address: nicolas.elie@unicaen.fr.
authors.forename: N
authors.initials: N
authors.lastname: Elie
authors.affiliation: Biochemistry Unit, Caen University Hospital, 14000 Caen, France; EA4650 Normandie université, GIP Cyceron, 14000 Caen, France. Electronic address: nowoczyn-m@chu-caen.fr.
authors.forename: M
authors.initials: M
authors.lastname: Nowoczyn
authors.affiliation: Radiology Department, Saint-Etienne University Hospital, 42000 Saint-Etienne, France; CREATIS CNRS UMR5220 Inserm U1044, Lyon University, 69000 Lyon, France. Electronic address: pierre.croisille@creatis.univ-lyon1.fr.
authors.forename: P
authors.initials: P
authors.lastname: Croisille
authors.affiliation: Biochemistry Unit, Caen University Hospital, 14000 Caen, France; EA4650 Normandie université, GIP Cyceron, 14000 Caen, France. Electronic address: coulbault-l@chu-caen.fr.
authors.forename: L
authors.initials: L
authors.lastname: Coulbault
authors.affiliation: Pathology Department, F.-Baclesse Cancer Center, 14000 Caen, France. Electronic address: c.bor-angelier@baclesse.fr.
authors.forename: C
authors.initials: C
authors.lastname: Bor-Angelier
authors.affiliation: Biochemistry Unit, Caen University Hospital, 14000 Caen, France; EA4650 Normandie université, GIP Cyceron, 14000 Caen, France. Electronic address: allouche-s@chu-caen.fr.
authors.forename: S
authors.initials: S
authors.lastname: Allouche
authors.affiliation: Nuclear Medicine Department, Caen University Hospital, 14033 Caen, France; EA4650 Normandie université, GIP Cyceron, 14000 Caen, France. Electronic address: manrique@cyceron.fr.
authors.forename: A
authors.initials: A
authors.lastname: Manrique
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000032:analysis / Q000502:physiology*; D057791:Cardiac Imaging Techniques; D003921:Diabetes Mellitus, Experimental / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006943:Hyperglycemia / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017202:Myocardial Ischemia; D015425:Myocardial Reperfusion; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D013311:Streptozocin; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D013311:Streptozocin
keywords: Animals; Cardiac magnetic resonance imaging; Diabetes; Glycaemic variability; Myocardial ischaemia/reperfusion; Myocardial oedema