Altered Myocardial Substrate Metabolism and Decreased Diastolic Function in Nonischemic Human Diabetic Cardiomyopathy
Key result
Uncomplicated type 2 diabetes is linked to decreased LV diastolic function and altered myocardial metabolism.
- P=0.003
- n=102
Why the study?
Whether myocardial metabolic derangements exist in uncomplicated human type 2 diabetes and contribute to myocardial dysfunction remained undetermined.
Are myocardial substrate metabolism and diastolic function altered in asymptomatic men with uncomplicated type 2 diabetes compared to normoglycemic controls?
Population
78 insulin-naive type 2 diabetes men without ischemia and 24 normoglycemic control subjects
Comparison
Type 2 diabetes men vs normoglycemic control subjects
Design
Cross-sectional comparative study
Authors
Discussion
Loading...
Member takes
Implication
Metabolic targets in diabetic cardiomyopathy merit prospective trials; should not yet change practice.
Key Points
- To evaluate myocardial substrate metabolism and diastolic function in type 2 diabetes and its association with myocardial function.
- Assessing myocardial left ventricular function using magnetic resonance imaging in 78 type 2 diabetes men and 24 control subjects.
- Measuring myocardial perfusion and substrate metabolism by positron emission tomography with various tracers.
- Evaluating high-energy phosphate metabolism using phosphorous P-31 magnetic resonance spectroscopy.
- Patients had decreased LV diastolic function (E/A ratio: 1.04 vs. 1.26, p=0.003).
- Myocardial glucose uptake in patients was significantly lower (260 vs. 348 nmol/ml/min, p=0.015).
- Increased myocardial nonesterified fatty acid uptake (88 vs. 68 nmol/ml/min, p=0.021) and oxidation (85 vs. 63 nmol/ml/min, p=0.007) were observed.
Study Design
Type
Case-Control (n=102)
Structured PICO
Are myocardial substrate metabolism and diastolic function altered in asymptomatic men with uncomplicated type 2 diabetes compared to normoglycemic controls?
P
Population
102 asymptomatic men (78 with well-controlled type 2 diabetes without cardiac ischemia and 24 normoglycemic controls) assessed for myocardial function and metabolism.
C
Comparator
Normoglycemic control subjects
O
Outcome
Myocardial left ventricular (LV) function, myocardial perfusion, substrate metabolism, and cardiac high-energy phosphate (HEP) metabolismsurrogate
Main Result
Absolute Event Rate: 1.04% vs 1.26%
p-value: p=0.003
Asymptomatic men with uncomplicated type 2 diabetes exhibit impaired LV diastolic function and altered myocardial substrate metabolism, but these metabolic changes do not directly correlate with diastolic dysfunction.
Cite This Study
Rijzewijk et al. (2009) conducted a case-control in Type 2 diabetes (n=102). Type 2 diabetes vs. Normoglycemic control subjects was evaluated on Left ventricular diastolic function (E/A ratio) (p=0.003). Uncomplicated type 2 diabetes in asymptomatic men was associated with decreased LV diastolic function (E/A ratio 1.04 vs 1.26, p=0.003) and altered myocardial substrate metabolism compared to controls.