OP11: Metabolic and vascular determinants of increased left ventricular torsion in patients with type 2 diabetes mellitus

• Published in: Diabetes & metabolism Vol. 38; p. S102
• Main Authors: Kuehl, M, Steeds, R, Townend, J, Tahrani, A, Dubb, K, Hughes, S, Phan, T, Stevens, M.J
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01-11-2012
• Subjects: Endocrinology & Metabolism; Internal Medicine
• ISSN: 1262-3636
• DOI: 10.1016/S1262-3636(12)71578-1

Objective Left ventricular torsion is increased in uncomplicated type 2 diabetes (T2DM) which may be an early manifestation of cardiomyopathy. Our aim was to evaluate the relationship of torsion to energetic impairment and microvascular damage in healthy patients with T2DM. Methods 36 patients with T2DM without coronary artery disease as measured by a normal dobutamine stress echocardiography and 20 healthy control (HC) subjects were recruited. Magnetic resonance spectroscopy, standard, speckle tracking and contrast echocardiography, cardiovascular autonomic function (CAN) testing and skin endothelial poly (ADP-ribose) polymerase assessments were performed. Results Left ventricular (LV) torsion was increased in subjects with T2DM (2.6 ± 0.8°/cm) compared to HC (2.0 ± 0.5°/cm, p=0.002). Cardiac energetics were reduced in patients with T2DM compared to HC (1.1 ± 0.4 vs. 1.8 ± 0.5, p<0.0001), but were not associated with increased torsion. Endothelial PARP was increased by 19% (p=0.0001) in subjects with T2DM and correlated with LV apical rotation ((R Square 0.424 p=0.017) after adjustment for weight and BMI. Torsion correlated significantly with CAN (F(2, 31) = 3.5, p=0.043, eta square 0.2). Conclusion LV torsion is increased in healthy T2DM. Microvascular damage and autonomic dysfunction but not reduced cardiac energetics may play an important pathophysiological role in its development.