Left atrial dysfunction in type 2 diabetes mellitus: insights from cardiac MRI

Graça, Bruno; Ferreira, Maria João; Donato, Paulo; Gomes, Leonor; Caseiro-Alves, Filipe

doi:10.1007/s00330-014-3299-2

Cited by 26 publications

(35 citation statements)

References 28 publications

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“…Insulin resistance is a main element of MetS, linked with several pathogenetic defects that can lead to heart failure and CV mortality 36. This result is consistent with a previous magnetic resonance imaging study accounting a relationship between type 2 diabetes and impaired LA ejection fraction 37. This result is consistent with a previous magnetic resonance imaging study accounting a relationship between type 2 diabetes and impaired LA ejection fraction 37.…”

supporting

confidence: 90%

Early left atrial dysfunction is associated with suboptimal cardiovascular health

et al. 2019

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Aims: Two-dimensional speckle-tracking echocardiography can assess left atrial (LA) function by measuring atrial volumes and deformation parameters (strain, strain rate). This cross-sectional analysis explores the association between ideal CV health (CVH), LA function, and systemic biomarkers in healthy individuals from the Chilean MAUCO Cohort. Methods:We enrolled 95 MAUCO participants with different levels of CVH (mean age: 51 ± 8 years). We categorized participants into low or high CVH groups: A: 0-2, or B: 3-6 CVH risk factors. 2D echocardiography, glucose, insulin, total cholesterol, triglycerides, proBNP, hsCRP, insulin resistance index (HOMA), and right and left atrial strain (RASs and LASs, respectively) were determined.Results: LASs was lower in Group A, while systolic and diastolic blood pressure (BP), body mass index (BMI), insulin, HOMA, total cholesterol, triglycerides, and LV and RV end-diastolic volume were significantly higher in Group A than Group B (P < .01).Change in LASs was inversely correlated with insulin (P = .040), HOMA (P = .013), total cholesterol (P = .039), glycemia (P = .018), and BMI (P = .0.037). Conclusion:LASs during the reservoir phase was diminished in subjects with a lower level of CVH. Higher insulin, HOMA, total cholesterol, glycemia, and BMI

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confidence: 90%

Early left atrial dysfunction is associated with suboptimal cardiovascular health

et al. 2019

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“…29,36 In our study, diabetic rats showed asymptomatic cardiac dysfunction manifested as significant reductions in heart rate (HR), left ventricular eject fraction (LVEF), stroke work (SW) and cardiac output (CO), left ventricular F I G U R E 4 Nrf2/p62 signalling pathway played the key role in the ALP protection to high glucose-induced cardiomyopathy. We showed that reductions in cardiac nuclear translocation of Excessive oxidative stress induced by hyperglycaemia is a major mechanism of DCM and the subsequent cardiac dysfunction both in human and in animal models of diabetes.…”

Section: Discussionmentioning

confidence: 71%

Allopurinol reduces oxidative stress and activates Nrf2/p62 to attenuate diabetic cardiomyopathy in rats

Luo

Yan

et al. 2019

J Cellular Molecular Medi

101

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Allopurinol (ALP) attenuates oxidative stress and diabetic cardiomyopathy (DCM), but the mechanism is unclear. Activation of nuclear factor erythroid 2-related factor 2 (Nrf2) following the disassociation with its repressor Keap1 under oxidative stress can maintain inner redox homeostasis and attenuate DCM with concomitant attenuation of autophagy. We postulated that ALP treatment may activate Nrf2 to mitigate autophagy over-activation and consequently attenuate DCM. Streptozotocin-induced type 1 diabetic rats were untreated or treated with ALP (100 mg/kg/d) for 4 weeks and terminated after heart function measurements by echocardiography and pressure-volume conductance system. Cardiomyocyte H9C2 cells infected with Nrf2 siRNA or not were incubated with high glucose (HG, 25 mmol/L) concomitantly with ALP treatment. Cell viability, lactate dehydrogenase, 15-F2t-Isoprostane and superoxide dismutase (SOD) were measured with colorimetric enzyme-linked immunosorbent assays. ROS, apoptosis, was assessed by dihydroethidium staining and TUNEL, respectively. The Western blot and qRT-PCR were used to assess protein and mRNA variations. Diabetic rats showed significant reductions in heart rate (HR), left ventricular eject fraction (LVEF), stroke work (SW) and cardiac output (CO), left ventricular end-systolic volume (LVVs) as compared to non-diabetic control and ALP improved or normalized HR, LVEF, SW, CO and LVVs in diabetic rats (all P < .05).Hearts of diabetic rats displayed excessive oxidative stress manifested as increased levels of 15-F2t-Isoprostane and superoxide anion production, increased apoptotic cell death and cardiomyocytes autophagy that were concomitant with reduced expressions of Nrf2, heme oxygenase-1 (HO-1) and Keap1. ALP reverted all the abovementioned diabetes-induced biochemical changes except that it did not affect the levels of Keap1. In vitro, ALP increased Nrf2 and reduced the hyperglycaemia-induced increases of H9C2 cardiomyocyte hypertrophy, oxidative stress, apoptosis and autophagy, and enhanced cellular viability. Nrf2 gene silence cancelled these protective effects of ALP in H9C2 cells. Activation of Nrf2 subsequent to the suppression of | 1761 LUO et aL.

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“…Increased left atrial volume is a marker of diastolic dysfunction, and these patients have been shown to have higher rates of cardiovascular events, including atrial fibrillation, stroke, heart failure, hypertension, and all‐cause mortality . In patients with type 2 diabetes mellitus, left atrial dysfunction has been found to be significantly greater than controls …”

mentioning

confidence: 99%

“…2 In patients with type 2 diabetes mellitus, left atrial dysfunction has been found to be significantly greater than controls. 3 While vitamin D deficiency is typically thought to involve the musculoskeletal system, there has been significant evidence linking it with adverse cardiovascular events. 4 In the Framingham Offspring Study, individuals with vitamin D deficiency (25(OH)D3 < 37.5 nmol/L) had a hazard ratio of 1.62 for development of cardiovascular disease compared with those with normal levels.…”

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confidence: 99%

Vitamin D Attenuates Left Atrial Volume Changes in African American Males with Obesity and Prediabetes

et al. 2015

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Vitamin D deficiency is common among African Americans in the United States and is associated with increased cardiovascular disease risk. In this study, prediabetic African American males who were found to be vitamin D–deficient were randomized to vitamin D supplementation and assessed for changes in left atrial (LA) volume. Prediabetic African American males who were vitamin D–deficient (25(OH)D: 5.0–29 ng/mL) were randomized to high-dose ergocalciferol or placebo. Echocardiography was performed at baseline and at 1 year. Ejection fraction (EF), septal and posterior wall thickness, LA area, LA length, LA volume, E, A, septal and lateral e′ and a′, deceleration time, and isovolumetric relaxation time were collected. Eighty-one of 158 (51%) subjects received vitamin D2. Baseline characteristics were similar among both groups. In the placebo group, left atrial volume significantly increased on follow-up (LA volume increased 6.3 mL, P = 0.0025). Compared with placebo group, the treatment group with ergocalciferol had attenuated increases in left atrial volume (LA volume increased 2.6 mL, P = 0.29). Changes in left atrial volume persisted when indexed to body surface area. There was no significant difference in other diastolic parameters and blood pressure between groups. In conclusion, vitamin D–deficient prediabetic African American males who were treated with high-dose vitamin D2 were found to have attenuated increases in left atrial volume compared with controls over 12-month follow-up.

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Left atrial dysfunction in type 2 diabetes mellitus: insights from cardiac MRI

Cited by 26 publications

References 28 publications

Early left atrial dysfunction is associated with suboptimal cardiovascular health

Early left atrial dysfunction is associated with suboptimal cardiovascular health

Allopurinol reduces oxidative stress and activates Nrf2/p62 to attenuate diabetic cardiomyopathy in rats

Vitamin D Attenuates Left Atrial Volume Changes in African American Males with Obesity and Prediabetes

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