Lookup NU author(s): Dr Sophie Cassidy,
Dr Kate Hallsworth,
Dr Christian Thoma,
Dr Guy MacGowan,
Dr Kieren Hollingsworth,
Professor Chris Day,
Professor Roy Taylor,
Dr Djordje Jakovljevic,
Professor Michael Trenell
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background: Both non-alcoholic fatty liver disease (NAFLD) and Type 2 diabetes increase the risk of developing cardiovascular disease. The metabolic processes underlying NAFLD and Type 2 diabetes are part of an integrated mechanism but little is known about how these conditions may differentially affect the heart. We compared the impact of NAFLD and Type 2 diabetes on cardiac structure, function and metabolism.Methods: 19 adults with Type 2 diabetes (62 +/- 8 years), 19 adults with NAFLD (54 +/- 15 years) and 19 healthy controls (56 +/- 14 years) underwent assessment of cardiac structure, function and metabolism using high resolution magnetic resonance imaging, tagging and spectroscopy at 3.0 T.Results: Adults with NAFLD and Type 2 diabetes demonstrate concentric remodelling with an elevated eccentricity ratio compared to controls (1.05 +/- 0.3 vs. 1.12 +/- 0.2 vs. 0.89 +/- 0.2 g/ml; p < 0.05). Despite this, only the Type 2 diabetes group demonstrate significant systolic and diastolic dysfunction evidenced by a reduced stroke index (31 +/- 7vs. controls, 38 +/- 10, p < 0.05 ml/m(2)) and reduced E/A (0.9 +/- 0.4 vs. controls, 1.9 +/- 1.4, p < 0.05) respectively. The torsion to shortening ratio was higher in Type 2 diabetes compared to NAFLD (0.58 +/- 0.16 vs. 0.44 +/- 0.13; p < 0.05). Significant associations were observed between fasting blood glucose/HbA1c and diastolic parameters as well as the torsion to shortening ratio (all p < 0.05). Phosphocreatine/adenosine triphosphate ratio was not altered in NAFLD or Type 2 diabetes compared to controls.Conclusions: Changes in cardiac structure are evident in adults with Type 2 diabetes and NAFLD without overt cardiac disease and without changes in cardiac energy metabolism. Only the Type 2 diabetes group display diastolic and subendocardial dysfunction and glycemic control may be a key mediator of these cardiac changes. Therapies should be explored to target these preclinical cardiac changes to modify cardiovascular risk associated with Type 2 diabetes and NAFLD.
Author(s): Cassidy S, Hallsworth K, Thoma C, MacGowan GA, Hollingsworth KG, Day CP, Taylor R, Jakovljevic DG, Trenell MI
Publication type: Article
Publication status: Published
Journal: Cardiovascular Diabetology
Online publication date: 13/02/2015
Acceptance date: 28/01/2015
Date deposited: 09/06/2015
ISSN (electronic): 1475-2840
Publisher: BioMed Central Ltd.
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