title: Heart failure patients with prediabetes and newly diagnosed diabetes display abnormalities in myocardial metabolism.
abstract: In type 2 diabetes, a decrease in myocardial glucose uptake (MGU) may lower glucose oxidation and contribute to progression of chronic heart failure (CHF). However, it is unsettled whether CHF patients with prediabetes have abnormal MGU and myocardial blood flow (MBF) during normal physiological conditions.
  
  
  
  We studied 35 patients with CHF and reduced left ventricular ejections fraction (34 ± 9%) without overt T2D (mean HbA1c: 40 ± 4 mmol/mol) using echocardiography and quantitative measurements of MGU by 18F-FDG-PET and perfusion by 15O-H2O-PET. An oral glucose tolerance test (OGTT) was performed during the FDG-PET, which identified 17 patients with abnormal and 18 patients with normal glucometabolic response. Global MGU was higher in patients with normal OGTT response (0.31 ± 0.09 µmol/g/min) compared with patients with abnormal OGTT response (0.25 ± 0.09 µmol/g/min) (P = 0.05). MBF (P = 0.22) and myocardial flow reserve (MFR) (P = 0.83) were similar in the study groups. The reduced MGU in prediabetic patients was attributable to reduced MGU in viable myocardium with normal MFR (P < 0.001).
  
  
  
  CHF patients with prediabetes have reduced MGU in segments with preserved MFR as compared to CHF patients with normal glucose tolerance. Whether reversal of these myocardial abnormalities can improve outcome needs to be investigated in large-scale studies.
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. roni.r.nielsen@gmail.com.
authors.forename: Roni
authors.initials: R
authors.lastname: Nielsen
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.|Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Jorsal
authors.affiliation: Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Iversen
authors.affiliation: Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Tolbod
authors.affiliation: Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bouchelouche
authors.affiliation: Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Sørensen
authors.affiliation: Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Hendrik Johannes
authors.initials: HJ
authors.lastname: Harms
authors.affiliation: Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.|Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Bøtker
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Wiggers
mesh_terms: D000368:Aged; D002921:Cicatrix / Q000000981:diagnostic imaging; D003326:Coronary Circulation; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000493:pharmacokinetics; D005951:Glucose Tolerance Test; D006321:Heart / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D000069450:Liraglutide / Q000008:administration & dosage; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D010477:Perfusion; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D019518:Postprandial Period; D011236:Prediabetic State / Q000150:complications*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
chemical_list: D019788:Fluorodeoxyglucose F18; D000069450:Liraglutide; D005947:Glucose
keywords: Heart failure; diabetes, type 2; metabolic syndrome; nuclear cardiology and PET