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Diabetes mellitus and insulin resistance associate with left ventricular shape and torsion by cardiovascular magnetic resonance imaging in asymptomatic individuals from the multi-ethnic study of atherosclerosis.
J Cardiovasc Magn Reson. 2018 07 30; 20(1):53.JC

Abstract

BACKGROUND

Although diabetes mellitus (DM) and insulin resistance associate with adverse cardiac events, the associations of left ventricular (LV) remodeling and function with compromised glucose metabolism have not been fully evaluated in a general population. We used cardiovascular magnetic resonance (CMR) to evaluate how CMR indices are associated with DM or insulin resistance among participants before developing cardiac events.

METHODS

We studied 1476 participants who were free of clinical cardiovascular disease and who underwent tagged CMR in the Multi-Ethnic Study of Atherosclerosis (MESA). LV shape and longitudinal myocardial shortening and torsion were assessed by CMR. A higher sphericity index represents a more spherical LV shape. Multivariable linear regression was used to evaluate the associations of DM or homeostasis model assessment-estimated insulin resistance (HOMA-IR) with CMR indices.

RESULTS

In multiple linear regression, longitudinal shortening was lower in impaired fasting glucose than normal fasting glucose (NFG) (0.36% lower vs. NFG, p < 0.05); torsion was greater in treated DM (0.24 °/cm greater vs. NFG, p < 0.05) after full adjustments. Among participants without DM, greater log-HOMA-IR was correlated with greater LV mass (3.92 g/index, p < 0.05) and LV mass-to-volume ratio (0.05 /index, p < 0.01), and lower sphericity index (- 1.26/index, p < 0.01). Greater log-HOMA IR was associated with lower longitudinal shortening (- 0.26%/index, p < 0.05) and circumferential shortening (- 0.30%/index, p < 0.05). Torsion was positively correlated with log-HOMA-IR until 1.5 of log-HOMA-IR (0.16 °/cm/index, p = 0.030).), and tended to fall once above 1.5 of log-HOMA-IR (- 0.50 °/cm/index, p = 0.203). The sphericity index was associated negatively with LV mass-to-volume ratio (- 0.02/%, p < 0.001) and torsion (- 0.03°/cm/%, p < 0.001).

CONCLUSIONS

Glucose metabolism disorders are associated with LV concentric remodeling, less spherical shape, and reduced systolic myocardial shortening in the general population. Although torsion is higher in participants who are treated for DM and impaired insulin resistance, myocardial shortening was progressively decreased with higher HOMA-IR and torsion was increased only with less severe insulin resistance.

CLINICAL TRIAL REGISTRATION

Multi-Ethnic Study of Atherosclerosis (MESA): A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org/ . Study Start Date: January 1999 (NCT00005487).

Authors+Show Affiliations

Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA. St. Marianna University School of Medicine, Kawasaki, Japan.Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA.Offices of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA.Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA.Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA.Department of Biostatistics, University of Washington, Seattle, WA, USA.National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health Clinical Center, Bethesda, MD, USA.Department of Cardiology, Johns Hopkins University, Baltimore, MD, USA. jlima@jhmi.edu. Radiology and Epidemiology, Johns Hopkins University, Blalock 524D1, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA. jlima@jhmi.edu.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30064457

Citation

Yoneyama, Kihei, et al. "Diabetes Mellitus and Insulin Resistance Associate With Left Ventricular Shape and Torsion By Cardiovascular Magnetic Resonance Imaging in Asymptomatic Individuals From the Multi-ethnic Study of Atherosclerosis." Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance, vol. 20, no. 1, 2018, p. 53.
Yoneyama K, Venkatesh BA, Wu CO, et al. Diabetes mellitus and insulin resistance associate with left ventricular shape and torsion by cardiovascular magnetic resonance imaging in asymptomatic individuals from the multi-ethnic study of atherosclerosis. J Cardiovasc Magn Reson. 2018;20(1):53.
Yoneyama, K., Venkatesh, B. A., Wu, C. O., Mewton, N., Gjesdal, O., Kishi, S., McClelland, R. L., Bluemke, D. A., & Lima, J. A. C. (2018). Diabetes mellitus and insulin resistance associate with left ventricular shape and torsion by cardiovascular magnetic resonance imaging in asymptomatic individuals from the multi-ethnic study of atherosclerosis. Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance, 20(1), 53. https://doi.org/10.1186/s12968-018-0472-9
Yoneyama K, et al. Diabetes Mellitus and Insulin Resistance Associate With Left Ventricular Shape and Torsion By Cardiovascular Magnetic Resonance Imaging in Asymptomatic Individuals From the Multi-ethnic Study of Atherosclerosis. J Cardiovasc Magn Reson. 2018 07 30;20(1):53. PubMed PMID: 30064457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetes mellitus and insulin resistance associate with left ventricular shape and torsion by cardiovascular magnetic resonance imaging in asymptomatic individuals from the multi-ethnic study of atherosclerosis. AU - Yoneyama,Kihei, AU - Venkatesh,Bharath A, AU - Wu,Colin O, AU - Mewton,Nathan, AU - Gjesdal,Ola, AU - Kishi,Satoru, AU - McClelland,Robyn L, AU - Bluemke,David A, AU - Lima,João A C, Y1 - 2018/07/30/ PY - 2017/08/14/received PY - 2018/06/20/accepted PY - 2018/8/2/entrez PY - 2018/8/2/pubmed PY - 2019/3/15/medline KW - Glucose tolerance KW - Heart failure KW - Metabolic disease KW - Obesity KW - Strain SP - 53 EP - 53 JF - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JO - J Cardiovasc Magn Reson VL - 20 IS - 1 N2 - BACKGROUND: Although diabetes mellitus (DM) and insulin resistance associate with adverse cardiac events, the associations of left ventricular (LV) remodeling and function with compromised glucose metabolism have not been fully evaluated in a general population. We used cardiovascular magnetic resonance (CMR) to evaluate how CMR indices are associated with DM or insulin resistance among participants before developing cardiac events. METHODS: We studied 1476 participants who were free of clinical cardiovascular disease and who underwent tagged CMR in the Multi-Ethnic Study of Atherosclerosis (MESA). LV shape and longitudinal myocardial shortening and torsion were assessed by CMR. A higher sphericity index represents a more spherical LV shape. Multivariable linear regression was used to evaluate the associations of DM or homeostasis model assessment-estimated insulin resistance (HOMA-IR) with CMR indices. RESULTS: In multiple linear regression, longitudinal shortening was lower in impaired fasting glucose than normal fasting glucose (NFG) (0.36% lower vs. NFG, p < 0.05); torsion was greater in treated DM (0.24 °/cm greater vs. NFG, p < 0.05) after full adjustments. Among participants without DM, greater log-HOMA-IR was correlated with greater LV mass (3.92 g/index, p < 0.05) and LV mass-to-volume ratio (0.05 /index, p < 0.01), and lower sphericity index (- 1.26/index, p < 0.01). Greater log-HOMA IR was associated with lower longitudinal shortening (- 0.26%/index, p < 0.05) and circumferential shortening (- 0.30%/index, p < 0.05). Torsion was positively correlated with log-HOMA-IR until 1.5 of log-HOMA-IR (0.16 °/cm/index, p = 0.030).), and tended to fall once above 1.5 of log-HOMA-IR (- 0.50 °/cm/index, p = 0.203). The sphericity index was associated negatively with LV mass-to-volume ratio (- 0.02/%, p < 0.001) and torsion (- 0.03°/cm/%, p < 0.001). CONCLUSIONS: Glucose metabolism disorders are associated with LV concentric remodeling, less spherical shape, and reduced systolic myocardial shortening in the general population. Although torsion is higher in participants who are treated for DM and impaired insulin resistance, myocardial shortening was progressively decreased with higher HOMA-IR and torsion was increased only with less severe insulin resistance. CLINICAL TRIAL REGISTRATION: Multi-Ethnic Study of Atherosclerosis (MESA): A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org/ . Study Start Date: January 1999 (NCT00005487). SN - 1532-429X UR - https://www.unboundmedicine.com/medline/citation/30064457/Diabetes_mellitus_and_insulin_resistance_associate_with_left_ventricular_shape_and_torsion_by_cardiovascular_magnetic_resonance_imaging_in_asymptomatic_individuals_from_the_multi_ethnic_study_of_atherosclerosis_ L2 - https://jcmr-online.biomedcentral.com/articles/10.1186/s12968-018-0472-9 DB - PRIME DP - Unbound Medicine ER -