2型糖尿病患者主动脉僵硬度和主动脉内血流参数与心外膜脂肪组织的关系

Khaoula Bouazizi, Mohamed Zarai, Abdallah Noufaily, Mikaël Prigent, Thomas Dietenbeck, Emilie Bollache, Toan Nguyen, Valéria Della Valle, Eléonore Blondiaux, Karine Clément, Judith Aron-Wisnewsky, Fabrizio Andreelli, Alban Redheuil, Nadjia Kachenoura
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引用次数: 0

摘要

背景:研究表明,主动脉僵硬度增加与2型糖尿病(T2D)有关,后者被认为是心血管疾病的危险因素。在其他危险因素中,心外膜脂肪组织(EAT)在T2D中增加,是代谢严重程度和不良后果的相关生物标志物。目的:评估T2D患者的主动脉血流参数与健康人的比较,并评估其与作为T2D患者心脏代谢严重程度指标的EAT积累的关系。材料与方法:选取36例t2dm患者和29例年龄、性别匹配的健康对照。参与者在1.5 t时进行心脏和主动脉MRI检查,成像序列包括左心室(LV)功能和EAT评估的电影SSFP和主动脉应变和流量参数量化的电影和相对比成像。结果:在本研究中,我们发现尽管整体左室质量在正常范围内,但左室表型的特征是同心重构,卒中容积指数下降。与对照组相比,T2D患者的EAT增加(结论:在我们的研究中,由向后血流容量增加和扩张性降低所描述的主动脉僵硬似乎与T2D患者的EAT容量有关。这一观察结果应该在未来更大的人群中得到证实,同时考虑到炎症特异性的其他生物标志物,并使用纵向前瞻性研究设计。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Associations of aortic stiffness and intra-aortic flow parameters with epicardial adipose tissue in patients with type-2 diabetes.

Background: It has been shown that increased aortic stiffness is related to type-2 diabetes (T2D) which is considered as a risk factor for cardiovascular disease. Among other risk factors is epicardial adipose tissue (EAT) which is increased in T2D and is a relevant biomarker of metabolic severity and adverse outcome.

Purpose: To assess aortic flow parameters in T2D patients as compared to healthy individuals and to evaluate their associations with EAT accumulation as an index of cardiometabolic severity in T2D patients.

Materials and methods: Thirty-six T2D patients as well as 29 healthy controls matched by age and sex were included in this study. Participants had cardiac and aortic MRI exams at 1.5 T. Imaging sequences included cine SSFP for left ventricle (LV) function and EAT assessment and aortic cine and phase-contrast imaging for strain and flow parameters quantification.

Results: In this study, we found LV phenotype to be characterized by concentric remodeling with decreased stroke volume index despite global LV mass within a normal range. EAT was increased in T2D patients compared to controls (p<0.0001). Moreover, EAT, a biomarker of metabolic severity, was negatively correlated to ascending aortic (AA) distensibility (p=0.048) and positively to the normalized backward flow volume (p=0.001). These relationships remained significant after further adjustment for age, sex and central mean blood pressure. In a multivariate model, presence/absence of T2D and AA normalized backward flow (BF) to forward flow (FF) volumes ratio are both significant and independent correlates of EAT.

Conclusion: In our study, aortic stiffness as depicted by an increased backward flow volume and decreased distensibility seems to be related to EAT volume in T2D patients. This observation should be confirmed in the future on a larger population while considering additional biomarkers specific to inflammation and using a longitudinal prospective study design.

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