Increased Left Ventricular Torsion in Uncomplicated Type 1 Diabetic Patients
The role of coronary microvascular function
- Ganesh Nallur Shivu, MRCP1,
- Khalid Abozguia, MRCP2,
- Thanh Trung Phan, MRCP2,
- Ibrar Ahmed, MRCP2,
- Rebekah Weaver, MSC1,
- Parth Narendran, PHD1,
- Martin Stevens, MD1 and
- Michael Frenneaux, MD, FRCP1
- 1Department of Cardiovascular Medicine, University of Birmingham, Birmingham, U.K.;
- 2University of Birmingham, Birmingham, U.K.
- Corresponding author: Ganesh Nallur Shivu, drgani23{at}gmail.com.
Abstract
OBJECTIVE We used speckle tracking echocardiography to study the early changes in left ventricular (LV) torsion in young patients with uncomplicated type 1 diabetes and stress magnetic resonance imaging (MRI) to assess its interrelationships with coronary microangiopathy.
RESEARCH DESIGN AND METHODS We recruited 33 asymptomatic subjects with type 1 diabetes and 32 age-matched healthy control subjects. All subjects underwent echocardiograms. Stress MRIs were performed in 30 subjects (8 healthy control subjects) to compute myocardial perfusion reserve index (MPRI).
RESULTS A significant increase in LV torsion (2 ± 0.7 vs. 1.4 ± 0.7°/cm, P < 0.05) was identified in longer-term and retinopathy-positive type 1 diabetic subjects (1.9 ± 0.7 vs. 1.4 ± 0.7°/cm, P < 0.05) as compared with the healthy control subjects. The MPRI was independently associated with increased LV torsion.
CONCLUSIONS We demonstrate that LV torsion is increased in young patients with uncomplicated type 1 diabetes and that coronary microvascular disease may play a key pathophysiological role in the development of increased LV torsion.
Footnotes
-
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
-
- Received March 2, 2009.
- Accepted May 31, 2009.
- © 2009 by the American Diabetes Association.
