Relationship between coronary microvascular dysfunction and cardiac energetics impairment in type 1 diabetes mellitus.

G. Nallur Shivu, T. T. Phan, K. Abozguia, I. Ahmed, A. Wagenmakers, A. Henning, P. Narendran, M. Stevens, M. Frenneaux

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

BACKGROUND: Asymptomatic subjects with diabetes mellitus have an impaired cardiac energetics status that may play a significant role in the development of heart failure. In the present study, we assessed the role of microvascular dysfunction in the development of impaired cardiac energetics in subjects with type 1 diabetes mellitus. METHODS AND RESULTS: Twenty-five asymptomatic subjects with type 1 diabetes mellitus (mean age +/-1 SD 33+/-8 years) and 26 age-, sex-, and body mass index-matched healthy control subjects (32+/-8 years old) were recruited into the study. The type 1 diabetes mellitus subjects were divided into 2 age-matched groups (newly diagnosed [<5 years] and longer-duration [>10 years] diabetes) to assess the impact of microvascular disease. All subjects had an echocardiogram and an exercise ECG performed, followed by magnetic resonance spectroscopy and stress magnetic resonance imaging. Compared with healthy control subjects, the phosphocreatine/gamma-ATP ratio was reduced significantly both in subjects with longer-term (2.1+/-0.5 versus 1.5+/-0.4, P<0.000) and newly diagnosed (2.1+/-0.5 versus 1.6+/-0.2, P<0.000) diabetes. The phosphocreatine/gamma-ATP ratio was similar in newly diagnosed diabetes subjects and those with longer-term disease (1.6+/-0.2 versus 1.5+/-0.4, P=0.32). The mean myocardial perfusion reserve index in the longer-term type 1 diabetes mellitus subjects was significantly lower than in healthy control subjects (1.7+/-0.6 versus 2.3+/-0.4, P=0.005). On univariate analysis, there was no significant correlation of phosphocreatine/gamma-ATP ratio with myocardial perfusion reserve index (r=0.21, P=0.26). CONCLUSIONS: We demonstrate that young subjects with uncomplicated type 1 diabetes mellitus have impaired myocardial energetics irrespective of the duration of diabetes and that the impaired cardiac energetics status is independent of coronary microvascular function. We postulate that impairment of cardiac energetics in these subjects primarily results from metabolic dysfunction rather than microvascular impairment.

Original languageEnglish (US)
Pages (from-to)1209-1215
Number of pages7
JournalCirculation
Volume121
Issue number10
DOIs
StatePublished - Mar 16 2010
Externally publishedYes

Fingerprint

Type 1 Diabetes Mellitus
Phosphocreatine
Healthy Volunteers
Adenosine Triphosphate
Perfusion
Diabetes Mellitus
Electrocardiography
Body Mass Index
Research Design
Magnetic Resonance Spectroscopy
Heart Failure
Age Groups
Magnetic Resonance Imaging
Exercise

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Relationship between coronary microvascular dysfunction and cardiac energetics impairment in type 1 diabetes mellitus. / Shivu, G. Nallur; Phan, T. T.; Abozguia, K.; Ahmed, I.; Wagenmakers, A.; Henning, A.; Narendran, P.; Stevens, M.; Frenneaux, M.

In: Circulation, Vol. 121, No. 10, 16.03.2010, p. 1209-1215.

Research output: Contribution to journalArticle

Shivu, GN, Phan, TT, Abozguia, K, Ahmed, I, Wagenmakers, A, Henning, A, Narendran, P, Stevens, M & Frenneaux, M 2010, 'Relationship between coronary microvascular dysfunction and cardiac energetics impairment in type 1 diabetes mellitus.', Circulation, vol. 121, no. 10, pp. 1209-1215. https://doi.org/10.1161/CIRCULATIONAHA.109.873273
Shivu, G. Nallur ; Phan, T. T. ; Abozguia, K. ; Ahmed, I. ; Wagenmakers, A. ; Henning, A. ; Narendran, P. ; Stevens, M. ; Frenneaux, M. / Relationship between coronary microvascular dysfunction and cardiac energetics impairment in type 1 diabetes mellitus. In: Circulation. 2010 ; Vol. 121, No. 10. pp. 1209-1215.
@article{e647fe09243a49cfb38469e9bfbd3c9b,
title = "Relationship between coronary microvascular dysfunction and cardiac energetics impairment in type 1 diabetes mellitus.",
abstract = "BACKGROUND: Asymptomatic subjects with diabetes mellitus have an impaired cardiac energetics status that may play a significant role in the development of heart failure. In the present study, we assessed the role of microvascular dysfunction in the development of impaired cardiac energetics in subjects with type 1 diabetes mellitus. METHODS AND RESULTS: Twenty-five asymptomatic subjects with type 1 diabetes mellitus (mean age +/-1 SD 33+/-8 years) and 26 age-, sex-, and body mass index-matched healthy control subjects (32+/-8 years old) were recruited into the study. The type 1 diabetes mellitus subjects were divided into 2 age-matched groups (newly diagnosed [<5 years] and longer-duration [>10 years] diabetes) to assess the impact of microvascular disease. All subjects had an echocardiogram and an exercise ECG performed, followed by magnetic resonance spectroscopy and stress magnetic resonance imaging. Compared with healthy control subjects, the phosphocreatine/gamma-ATP ratio was reduced significantly both in subjects with longer-term (2.1+/-0.5 versus 1.5+/-0.4, P<0.000) and newly diagnosed (2.1+/-0.5 versus 1.6+/-0.2, P<0.000) diabetes. The phosphocreatine/gamma-ATP ratio was similar in newly diagnosed diabetes subjects and those with longer-term disease (1.6+/-0.2 versus 1.5+/-0.4, P=0.32). The mean myocardial perfusion reserve index in the longer-term type 1 diabetes mellitus subjects was significantly lower than in healthy control subjects (1.7+/-0.6 versus 2.3+/-0.4, P=0.005). On univariate analysis, there was no significant correlation of phosphocreatine/gamma-ATP ratio with myocardial perfusion reserve index (r=0.21, P=0.26). CONCLUSIONS: We demonstrate that young subjects with uncomplicated type 1 diabetes mellitus have impaired myocardial energetics irrespective of the duration of diabetes and that the impaired cardiac energetics status is independent of coronary microvascular function. We postulate that impairment of cardiac energetics in these subjects primarily results from metabolic dysfunction rather than microvascular impairment.",
author = "Shivu, {G. Nallur} and Phan, {T. T.} and K. Abozguia and I. Ahmed and A. Wagenmakers and A. Henning and P. Narendran and M. Stevens and M. Frenneaux",
year = "2010",
month = "3",
day = "16",
doi = "10.1161/CIRCULATIONAHA.109.873273",
language = "English (US)",
volume = "121",
pages = "1209--1215",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Relationship between coronary microvascular dysfunction and cardiac energetics impairment in type 1 diabetes mellitus.

AU - Shivu, G. Nallur

AU - Phan, T. T.

AU - Abozguia, K.

AU - Ahmed, I.

AU - Wagenmakers, A.

AU - Henning, A.

AU - Narendran, P.

AU - Stevens, M.

AU - Frenneaux, M.

PY - 2010/3/16

Y1 - 2010/3/16

N2 - BACKGROUND: Asymptomatic subjects with diabetes mellitus have an impaired cardiac energetics status that may play a significant role in the development of heart failure. In the present study, we assessed the role of microvascular dysfunction in the development of impaired cardiac energetics in subjects with type 1 diabetes mellitus. METHODS AND RESULTS: Twenty-five asymptomatic subjects with type 1 diabetes mellitus (mean age +/-1 SD 33+/-8 years) and 26 age-, sex-, and body mass index-matched healthy control subjects (32+/-8 years old) were recruited into the study. The type 1 diabetes mellitus subjects were divided into 2 age-matched groups (newly diagnosed [<5 years] and longer-duration [>10 years] diabetes) to assess the impact of microvascular disease. All subjects had an echocardiogram and an exercise ECG performed, followed by magnetic resonance spectroscopy and stress magnetic resonance imaging. Compared with healthy control subjects, the phosphocreatine/gamma-ATP ratio was reduced significantly both in subjects with longer-term (2.1+/-0.5 versus 1.5+/-0.4, P<0.000) and newly diagnosed (2.1+/-0.5 versus 1.6+/-0.2, P<0.000) diabetes. The phosphocreatine/gamma-ATP ratio was similar in newly diagnosed diabetes subjects and those with longer-term disease (1.6+/-0.2 versus 1.5+/-0.4, P=0.32). The mean myocardial perfusion reserve index in the longer-term type 1 diabetes mellitus subjects was significantly lower than in healthy control subjects (1.7+/-0.6 versus 2.3+/-0.4, P=0.005). On univariate analysis, there was no significant correlation of phosphocreatine/gamma-ATP ratio with myocardial perfusion reserve index (r=0.21, P=0.26). CONCLUSIONS: We demonstrate that young subjects with uncomplicated type 1 diabetes mellitus have impaired myocardial energetics irrespective of the duration of diabetes and that the impaired cardiac energetics status is independent of coronary microvascular function. We postulate that impairment of cardiac energetics in these subjects primarily results from metabolic dysfunction rather than microvascular impairment.

AB - BACKGROUND: Asymptomatic subjects with diabetes mellitus have an impaired cardiac energetics status that may play a significant role in the development of heart failure. In the present study, we assessed the role of microvascular dysfunction in the development of impaired cardiac energetics in subjects with type 1 diabetes mellitus. METHODS AND RESULTS: Twenty-five asymptomatic subjects with type 1 diabetes mellitus (mean age +/-1 SD 33+/-8 years) and 26 age-, sex-, and body mass index-matched healthy control subjects (32+/-8 years old) were recruited into the study. The type 1 diabetes mellitus subjects were divided into 2 age-matched groups (newly diagnosed [<5 years] and longer-duration [>10 years] diabetes) to assess the impact of microvascular disease. All subjects had an echocardiogram and an exercise ECG performed, followed by magnetic resonance spectroscopy and stress magnetic resonance imaging. Compared with healthy control subjects, the phosphocreatine/gamma-ATP ratio was reduced significantly both in subjects with longer-term (2.1+/-0.5 versus 1.5+/-0.4, P<0.000) and newly diagnosed (2.1+/-0.5 versus 1.6+/-0.2, P<0.000) diabetes. The phosphocreatine/gamma-ATP ratio was similar in newly diagnosed diabetes subjects and those with longer-term disease (1.6+/-0.2 versus 1.5+/-0.4, P=0.32). The mean myocardial perfusion reserve index in the longer-term type 1 diabetes mellitus subjects was significantly lower than in healthy control subjects (1.7+/-0.6 versus 2.3+/-0.4, P=0.005). On univariate analysis, there was no significant correlation of phosphocreatine/gamma-ATP ratio with myocardial perfusion reserve index (r=0.21, P=0.26). CONCLUSIONS: We demonstrate that young subjects with uncomplicated type 1 diabetes mellitus have impaired myocardial energetics irrespective of the duration of diabetes and that the impaired cardiac energetics status is independent of coronary microvascular function. We postulate that impairment of cardiac energetics in these subjects primarily results from metabolic dysfunction rather than microvascular impairment.

UR - http://www.scopus.com/inward/record.url?scp=77950473439&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77950473439&partnerID=8YFLogxK

U2 - 10.1161/CIRCULATIONAHA.109.873273

DO - 10.1161/CIRCULATIONAHA.109.873273

M3 - Article

C2 - 20194884

AN - SCOPUS:77950473439

VL - 121

SP - 1209

EP - 1215

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 10

ER -