Background Type 2 diabetes mellitus causes left ventricular (LV) remodeling and increases the risk of aortic regurgitation (AR), which causes further heart damage. This study aimed to investigate whether AR aggravates LV deformation dysfunction and to identify independent factors affecting the global peak strain (PS) of LV remodeling in patients with type 2 diabetes mellitus (T2DM) who presented with AR and those without T2DM. Methods In total, 215 patients with T2DM and 83 age- and sex-matched healthy controls who underwent cardiac magnetic resonance examination were included. Based on the echocardiogram findings, T2DM patients with AR were divided into three groups (mild AR [n = 28], moderate AR [n = 21], and severe AR [n = 17]). LV function and global strain parameters were compared, and multivariate analysis was performed to identify the independent indicators of LV PS. Results The T2DM patients with AR had a lower LV global PS, peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR) in three directions than those without AR and non-T2DM controls. Patients without AR had a lower PS (radial and longitudinal) and PDSR in three directions and higher PSSR (radial and longitudinal) than healthy controls. Further, regurgitation degree was an independent factor of LV global radial, circumferential, and longitudinal PS. Conclusion AR may aggravate LV stiffness in patients with T2DM, resulting in lower LV strain and function. Regurgitation degree and sex were independently correlated with LV global PS in patients with T2DM and AR.

BackgroundMetabolic dysfunction‐associated fatty liver disease (MAFLD) was recently recognized as an important risk factor for cardiovascular diseases.PurposeTo examine the effect of MAFLD on cardiac function in metabolic syndrome by MRI.Study TypeRetrospective.PopulationOne hundred seventy‐nine patients with metabolic syndrome (MetS), 101 with MAFLD (MAFLD [+]) and 78 without (MAFLD [−]). Eighty‐one adults without any of the components of MetS or cardiac abnormalities were included as control group.Field Strength/Sequence3.0 T; balanced steady‐state free precession sequence.AssessmentLeft atrial (LA) strain was assessed during three phases: reservoir strain (LA‐RS), conduit strain (LA‐CS), and booster strain (LA‐BS). Left ventricular (LV) global longitudinal (LV‐GLS) strain was also derived. The left atrioventricular coupling index (LACI) was calculated as the ratio of LA end‐diastolic volume (LA‐EDV) and LV‐EDV.Statistical TestsStudent's t test or Mann–Whitney U test; One‐way analysis of variance. A P value <0.05 was considered statistically significant.ResultsAmong MetS patients, individuals with MAFLD had significantly lower magnitude LV‐GLS (−11.6% ± 3.3% vs. −13.8% ± 2.7%) than those without MAFLD. For LA strains, LA‐RS (36.9% ± 13.7% vs. 42.9% ± 13.5%) and LA‐CS (20.0% ± 10.6% vs. 24.1% ± 9.2%) were also significantly reduced in MAFLD (+) compared to MAFLD (−). The LACIs (17.2% [12.9–21.2] % vs. 15.8% [12.2–19.7] %) were significantly higher in patients with MAFLD compared to those without MAFLD. After adjustment for other clinical factors, MAFLD was found to be independently correlated with LV‐GLS (β = −0.270) and LACI (β = 0.260).Data ConclusionMAFLD had an unfavorable effect on LV myocardial strain in MetS. Moreover, LA strain and atrioventricular coupling were further impaired in patients with concomitant MAFLD compared to those without MAFLD. Last, MAFLD was independently associated with subclinical LV dysfunction and atrioventricular coupling after adjustment for other clinical factors.Evidence Level3Technical Efficacy3

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