Diabetes
Diabetes
5 years ago

Metabolic Syndrome is Associated with Impaired Diastolic Function Independently of Mri-Derived Myocardial Extracellular Volume: the Mesa Study.

Ricardo Fontes-Carvalho, Alain G Bertoni, Bharath Ambale-Venkatesh, Kiang Liu, Colin Wu, Francisco Sampaio, David A Bluemke, Pamela Ouyang, João A Lima, Ricardo Ladeiras-Lopes, Nuno Bettencourt, Henrique T Moreira
The relationship of MetS (metabolic syndrome) 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 magnetic resonance imaging (CMR) in a large community-based population.This cross-sectional analysis included 1,582 participants from the Multi-Ethnic Study of Atherosclerosis with left ventricular ejection fraction ≥50% and no past history of cardiac events. Diastolic function was assessed using tagged-CMR 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), independently 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 cardiomyocytes' alterations, irrespective of the myocardial interstitium (including fibrosis).

Publisher URL: http://doi.org/10.2337/db17-1496

DOI: 10.2337/db17-1496

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