TY - JOUR
T1 - Metabolic syndrome is associated with impaired diastolic function independently of MRI-derived myocardial extracellular volume
T2 - The MESA study
AU - Ladeiras-Lopes, Ricardo
AU - Moreira, Henrique T.
AU - Bettencourt, Nuno
AU - Fontes-Carvalho, Ricardo
AU - Sampaio, Francisco
AU - Ambale-Venkatesh, Bharath
AU - Wu, Colin
AU - Liu, Kiang
AU - Bertoni, Alain G.
AU - Ouyang, Pamela
AU - Bluemke, David A.
AU - Lima, João A.
N1 - Publisher Copyright:
© 2018 by the American Diabetes Association.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - The relationship of metabolic syndrome (MetS) and insulin resistance (one of its key pathophysiological mediators) with diastolic dysfunction and myocardial fibrosis is not well understood. This study aimed to evaluate the association of MetS with diastolic function and myocardial extracellular matrix (ECM) using cardiac MRI (CMRI) in a large community-based population. This cross-sectional analysis included 1,582 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with left ventricular eje ction fraction ≥50% and no history of cardiac events. Diastolic function was assessed using tagged CMRI parameters including end-diastolic strain rate (EDSR) and strain relaxation index (SRI). ECM was evaluated using extracellular volume (ECV) quantification. Participants' mean age was 67.4 ± 8.6 years, and 48.1% were males. MetS was present in 533 individuals (33.7%), and type 2 diabetes in 250 (15.8%). In the multivariable analyses, MetS (irrespective of the presence of type 2 diabetes) and higher insulin resistance were associated with impaired diastolic function (higher SRI and lower EDSR), independent of ECV. In conclusion, MetS, irrespective of the presence of type 2 diabetes, was independently associated with impaired diastole. These functional myocardial changes seem to result from intrinsic cardiomyocyte alterations, irrespective of the myocardial interstitium (including fibrosis).
AB - The relationship of metabolic syndrome (MetS) and insulin resistance (one of its key pathophysiological mediators) with diastolic dysfunction and myocardial fibrosis is not well understood. This study aimed to evaluate the association of MetS with diastolic function and myocardial extracellular matrix (ECM) using cardiac MRI (CMRI) in a large community-based population. This cross-sectional analysis included 1,582 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with left ventricular eje ction fraction ≥50% and no history of cardiac events. Diastolic function was assessed using tagged CMRI parameters including end-diastolic strain rate (EDSR) and strain relaxation index (SRI). ECM was evaluated using extracellular volume (ECV) quantification. Participants' mean age was 67.4 ± 8.6 years, and 48.1% were males. MetS was present in 533 individuals (33.7%), and type 2 diabetes in 250 (15.8%). In the multivariable analyses, MetS (irrespective of the presence of type 2 diabetes) and higher insulin resistance were associated with impaired diastolic function (higher SRI and lower EDSR), independent of ECV. In conclusion, MetS, irrespective of the presence of type 2 diabetes, was independently associated with impaired diastole. These functional myocardial changes seem to result from intrinsic cardiomyocyte alterations, irrespective of the myocardial interstitium (including fibrosis).
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U2 - 10.2337/db17-1496
DO - 10.2337/db17-1496
M3 - Article
C2 - 29444891
AN - SCOPUS:85046008716
SN - 0012-1797
VL - 67
SP - 1007
EP - 1012
JO - Diabetes
JF - Diabetes
IS - 5
ER -