期刊
INTERNATIONAL JOURNAL OF CARDIOLOGY
卷 363, 期 -, 页码 179-184出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2022.06.049
关键词
Diabetes; Diabetic cardiomyopathy; Cardiovascular magnetic resonance; Magnetic resonance imaging; Metabolomics
资金
- National Heart Foundation of Australia [105849]
- Post -Doctoral Scholarship
- National Heart Foundation of Australia
This study aims to identify biomarkers of cardiomyopathy in T2DM patients and explore the associations between functional status, metabolomic profile, and myocardial fibrosis. The results show that patients with well-controlled T2DM exhibit myocardial fibrosis, which is associated with reduced exercise tolerance and specific metabolites.
Aims: To identify biomarkers of cardiomyopathy in patients with type 2 diabetes mellitus (T2DM) using cardiovascular magnetic resonance (CMR) and to identify associations between functional status, metabolomic profile and myocardial fibrosis. Methods: In this prospective case control study, patients (n = 49) with T2DM without significant coronary artery disease, and matched controls (n = 18) underwent CMR, cardiopulmonary exercise testing, and plasma metabolomic analyses. Results: Patients with T2DM (n = 49, median [interquartile range] age 61 [56-63] years, 61% male, diabetes duration 11 [7-20] years), historical HbA1c 7.6% (60 mmol/mol) (6.9-8.6) and matched controls (n = 18) were examined. Study patients had increased myocardial extracellular volume (ECV) (26.9 [23.8-30.0] vs 23.4 [22.4-25.5) %, p < 0.001). Increased ECV was associated with male sex (p = 0.04), time with T2DM (p = 0.02), reduced peak VO2 (R2 = 0.48, p = 0.01), increased circulating choline (p = 0.002) and cysteamine (p = 0.002) both of which were also associated with reduced peak VO2 (p < 0.025 and 0.014 respectively). Conclusions: Patients with well-controlled T2DM without significant coronary disease exhibit focal and diffuse myocardial fibrosis and diffuse myocardial fibrosis is associated with reduced exercise tolerance and metabolites. Plasma metabolites may provide mechanistic insights into diffuse myocardial fibrosis, and cardiopulmonary fitness.
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