Relation of Aortic Stiffness to Left Ventricular Remodeling in Younger Adults With Type 2 Diabetes
Relation of Aortic Stiffness to Left Ventricular Remodeling in Younger Adults With Type 2 Diabetes
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DOI：
10.2337/db18-0112
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发表时间：
2018-07-01
期刊：
影响因子：
7.7
通讯作者：
McCann, Gerry P.
中科院分区：
文献类型：
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作者：
Gulsin, Gaurav S.;Swarbrick, Daniel J.;McCann, Gerry P.
2 型糖尿病患者发生心力衰竭的风险增加三到五倍。糖尿病心肌病的典型特征是左心室（LV）同心重塑，这是公认的不良心血管事件的预测因子。尽管 2 型糖尿病左室重塑的机制尚不清楚，但进行性主动脉硬化可能是一个关键的决定因素。本研究的目的是使用多参数心血管 MRI 评估年轻 2 型糖尿病患者的主动脉僵硬度与左室几何形状之间的关系。我们前瞻性地招募了 80 名患有 2 型糖尿病且无心血管疾病的成年人（年龄 18-65 岁）以及 20 名年龄和性别匹配的健康对照受试者。所有受试者均接受了全面的生物人体测量评估和心脏 MRI，包括通过主动脉扩张性 (AD) 测量主动脉硬度。与对照组相比，2 型糖尿病与左心室质量增加、左心室同心重塑和 AD 降低有关。在多变量线性回归中，AD 与 2 型糖尿病同心左心室重构独立相关。因此，主动脉僵硬度可能是预防 2 型糖尿病心力衰竭发展的潜在治疗目标。
Individuals with type 2 diabetes have a three- to fivefold increased risk of developing heart failure. Diabetic cardiomyopathy is typified by left ventricular (LV) concentric remodeling, which is a recognized predictor of adverse cardiovascular events. Although the mechanisms underlying LV remodeling in type 2 diabetes are unclear, progressive aortic stiffening may be a key determinant. The aim of this study was to assess the relationship between aortic stiffness and LV geometry in younger adults with type 2 diabetes, using multiparametric cardiovascular MRI. We prospectively recruited 80 adults (aged 18-65 years) with type 2 diabetes and no cardiovascular disease and 20 age- and sex-matched healthy control subjects. All subjects underwent comprehensive bio-anthropometric assessment and cardiac MRI, including measurement of aortic stiffness by aortic distensibility (AD). Type 2 diabetes was associated with increased LV mass, concentric LV remodeling, and lower AD compared with control subjects. On multivariable linear regression, AD was independently associated with concentric LV remodeling in type 2 diabetes. Aortic stiffness may therefore be a potential therapeutic target to prevent the development of heart failure in type 2 diabetes.