Diastolic Dysfunction in Hypertensive Heart Disease Is Associated With Altered Myocardial Metabolism

Lamb, Hildo J.; Beyerbacht, Hugo P.; Laarse, Arnoud van der; Stoel, Berend C.; Doornbos, Joost; Wall, Ernst E. van der; Roos, Albert de

doi:10.1161/01.cir.99.17.2261

Cited by 214 publications

(138 citation statements)

References 46 publications

(70 reference statements)

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“…7 In support of this, we have shown not only that LV mass is predictive of diastolic function on linear regression but also that the PCr/ATP ratio is a predictor of diastolic function and is correlated with insulin resistance and LV mass. Although no direct proof of cause and effect, these findings suggest that impaired energy metabolism contributes to diastolic dysfunction in obesity and may be related to insulin resistance.…”

Section: Altered Energetics and Diastolic Function In Obesitysupporting

confidence: 66%

“…It is generally accepted that myocardial relaxation is determined largely by a combination of active (calcium homeostasis, myocardial energetics) 7 and passive processes related to the physical properties of the LV (intrinsic mechanical stiffness as determined by wall thickness and chamber geometry). 8 No studies to date have been able to investigate both active and passive elements of relaxation in obesity.…”

Section: Clinical Perspective On P 1519mentioning

confidence: 99%

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Effects of Catecholamine Stress on Diastolic Function and Myocardial Energetics in Obesity

et al. 2012

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Background-Obesity is characterized by impaired cardiac energetics, which may play a role in the development of diastolic dysfunction and inappropriate shortness of breath. We assessed whether, in obesity, derangement of energetics and diastolic function is further altered during acute cardiac stress. Methods and Results-Normal-weight (body mass index, 22Ϯ2 kg/m 2 ; nϭ9 -17) and obese (body mass index, 39Ϯ7 kg/m 2 ; nϭ17-46) subjects underwent assessment of diastolic left ventricular function (cine magnetic resonance imaging volume-time curve analysis) and cardiac energetics (phosphocreatine/ATP ratio; 31 P-magnetic resonance spectroscopy) at rest and during dobutamine stress (heart rate increase, 65Ϯ22% and 69Ϯ14%, respectively; Pϭ0.61). At rest, obesity was associated with a 22% lower peak filling rate (PϽ0.001) and a 15% lower phosphocreatine/ATP ratio (1.73Ϯ0.40 versus 2.03Ϯ0.28; Pϭ0.048). Peak filling rate correlated with fat mass, left ventricular mass, leptin, waist-to-hip ratio, and phosphocreatine/ATP ratio. On multivariable analysis, phosphocreatine/ATP was the only independent predictor of peak filling rate (␤ϭ0.50; Pϭ0.03). During stress, a further reduction in phosphocreatine/ATP occurred in obese (from 1.73Ϯ0.40 to 1.53Ϯ0.50; Pϭ0.03) but not in normal-weight (from 1.98Ϯ0.24 to 2.04Ϯ0.34; Pϭ0.50) subject. For similar levels of inotropic stress, there were smaller increases in peak filling rate in obesity (38% versus 70%; Pϭ0.01). Conclusions-In

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Section: Altered Energetics and Diastolic Function In Obesitysupporting

confidence: 66%

Section: Clinical Perspective On P 1519mentioning

confidence: 99%

Effects of Catecholamine Stress on Diastolic Function and Myocardial Energetics in Obesity

et al. 2012

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“…In the present study, both MRI and TDI were used for the evaluation of diastolic function after intramyocardial bone marrow cell injection. MR phase contrast flow velocity mapping allows measurement of flow-velocity as well as flow-volumes across the mitral valve orifice, providing a new means of diastolic function assessment that may even be a more sensitive method than Doppler echocardiography (9,11,12). Flow velocity mapping revealed an increase in the E/A peak flow ratio at the three-month follow-up, which was mainly determined by an improvement in the E peak filling rate, whereas the A peak filling rate remained unchanged.…”

Section: Discussionmentioning

confidence: 99%

Effect of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia

Beeres

Lamb

Roes

et al. 2008

Magnetic Resonance Imaging

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Purpose:To evaluate the effect of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia. Materials and Methods:In 24 patients (19 male; 65 Ϯ 9 years) with refractory angina (Canadian Cardiovascular Society [CCS] class III-IV) 84.6 Ϯ 28.7 ϫ 10 6 bone marrowderived mononuclear cells were injected intramyocardially (using the NOGA system) in regions with ischemia on Tc99m tetrofosmin single photon emission computed tomography (SPECT). Diastolic function was evaluated at baseline and at three months using magnetic resonance imaging (MRI) and tissue Doppler imaging (TDI).Results: MRI revealed an increased early (E) peak filling rate (374 Ϯ 121 mL/second vs. 412 Ϯ 102 mL/second; P ϭ 0.04), whereas the atrial (A) peak filling rate remained unchanged (340 Ϯ 81 mL/second vs. 334 Ϯ 93 mL/second; P ϭ not significant [NS]). The E/A peak flow ratio increased from 1.09 Ϯ 0.33 to 1.23 Ϯ 0.47 at three months (P ϭ 0.02). TDI demonstrated a significant improvement in early diastolic velocity (EЈ) from 4.4 Ϯ 1.7 cm/second to 4.8 Ϯ 1.6 cm/second at three months (P ϭ 0.03), whereas the late diastolic velocity (AЈ) remained unchanged (6.0 Ϯ 1.6 cm/ second vs. 6.0 Ϯ 1.7 cm/second; P ϭ NS). Consequently, the EЈ/AЈ ratio increased from 0.74 Ϯ 0.19 to 0.84 Ϯ 0.28 at three months (P ϭ 0.02). Conclusion:Intramyocardial bone marrow cell injection in patients with chronic myocardial ischemia improved MRI and TDI-derived parameters of diastolic function.

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“…In support of the first potential explanation, the individuals belonging to quartile IV were characterized by slightly higher systolic blood pressure in comparison with the individuals of quartiles I and II (Table 1) and showed higher end diastolic wall mass (Table 2). In patients with hypertension and LV hypertrophy, PCr-to-ATP ratio was reduced (17), and this reduction was associated with the progression of heart failure in patients with dilated and hypertrophic cardiomyopathy (18). The second plausible explanation was supported by the fact that the individuals of quartile IV were characterized by reduced serum HDL cholesterol, increased serum triglycerides, and a trend for higher plasma glucose.…”

Section: Effects Of Hemodynamic and Metabolic Variables On The Correlmentioning

confidence: 99%

Abnormal Left Ventricular Energy Metabolism in Obese Men With Preserved Systolic and Diastolic Functions Is Associated With Insulin Resistance

Perseghin

Ntali²,

Cobelli

et al. 2007

Diabetes Care

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OBJECTIVE -Perturbations in cardiac energy metabolism might represent early alterations in diabetes preceding functional and pathological changes. We evaluated left ventricular (LV) structure/geometry and function in relation to energy metabolism and cardiovascular risk factors in overweight/obese men using magnetic resonance techniques. RESULTS -LV mass increased across quartiles of BMI; meanwhile, the volumes did not differ. Parameters of LV systolic and diastolic function were not different among quartiles. The phosphocreatine-to-ATP ratio was reduced across increasing quartiles of mean Ϯ SD BMI (2.25 Ϯ 0.52, 1.89 Ϯ 0.26, 1.99 Ϯ 0.38, and 1.79 Ϯ 0.29; P Ͻ 0.006) in association with insulin sensitivity (computer homeostasis model assessment 2 model); this relation was independent of age, BMI, blood pressure, wall mass, HDL cholesterol, triglycerides, smoking habits, and metabolic syndrome. RESEARCH DESIGN AND METHODSCONCLUSIONS -Abnormal LV energy metabolism was detectable in obese men in the presence of normal function, supporting the hypothesis that metabolic remodeling in insulin resistant states precedes functional and structural/geometrical remodeling of the heart regardless of the onset of overt hyperglycemia. Diabetes Care 30:1520-1526, 2007C ardiovascular disease is the leading cause of death in patients with type 2 diabetes (1,2). The existence of a diabetic cardiomyopathy distinct from ischemic injury was confirmed, but the challenge of recognizing its specific features remained unresolved because diabetes could also provoke cardiac damage via coronary macrovascular disease, autonomic dysfunction, and coronary microvascular disease (3). It was proposed that altered metabolism and impaired insulin action in the heart might be cause and consequence of altered cardiac function (4) and that metabolic remodeling in diabetes might precede, cause, and sustain the functional and structural/geometrical remodeling of the heart (5). In keeping with this hypothesis, cardiac energy metabolism was found to be abnormal in patients with type 2 diabetes despite the lack of major cardiac dysfunctions (6) or the presence of diastolic dysfunction (7). Those studies were performed in middleage individuals (52-57 years old) in whom diabetes was diagnosed 1 (7) to 3 (6) years earlier. Therefore, the question whether the alterations of cardiac energy metabolism were due to the hyperglycemic state itself or whether they were secondary to the metabolic features characterizing the prediabetic state remained unanswered.This study was undertaken to assess whether obesity was associated with impaired cardiac structure/geometry, function, and energy metabolism and to establish whether these potential alterations were associated with the cardiovascular and metabolic risk factors accompanying insulin resistance conditions. RESEARCH DESIGN AND METHODSWe selected 81 apparently healthy men with no previous history of diabetes, hypertension, dyslipidemias, coronary, cerebral, or peripheral vascular events, no history of dilated cardiomy...

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Diastolic Dysfunction in Hypertensive Heart Disease Is Associated With Altered Myocardial Metabolism

Cited by 214 publications

References 46 publications

Effects of Catecholamine Stress on Diastolic Function and Myocardial Energetics in Obesity

Effects of Catecholamine Stress on Diastolic Function and Myocardial Energetics in Obesity

Effect of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia

Abnormal Left Ventricular Energy Metabolism in Obese Men With Preserved Systolic and Diastolic Functions Is Associated With Insulin Resistance

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