Similar patterns of myocardial metabolism and perfusion in patients with type 2 diabetes and heart disease of ischaemic and non-ischaemic origin

Masi, Stefano; Lautamäki, Riikka; Guiducci, Letizia; Cecco, Pietro Di; Porciello, C; Pardini, S.; Morales, Maria‐Aurora; Chubuchny, Vladyslav; Salvadori, Piero A.; Emdin, Michele; Sironi, Anna Maria; Knuuti, Juhani; Neglia, Danilo; Nuutila, Pirjo; Ferrannini, Ele; Iozzo, Patricia

doi:10.1007/s00125-012-2631-0

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…Additionally, the cross-sectional design and the observational nature of this study do not permit any causal inferences. Furthermore, we did not measure FFA levels, whose values are known to potentially influence the preferential substrate utilized by the myocardium [ 58 ], thus precluding us from determining the potential metabolic flexibility of study subjects.…”

Section: Discussionmentioning

confidence: 99%

Impaired insulin-stimulated myocardial glucose metabolic rate is associated with reduced estimated myocardial energetic efficiency in subjects with different degrees of glucose tolerance

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Papa

et al. 2023

Cardiovasc Diabetol

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Background Alterations in myocardial mechano-energetic efficiency (MEEi), which represents the capability of the left ventricles to convert the chemical energy obtained by oxidative metabolism into mechanical work, have been associated with cardiovascular disease. Although whole-body insulin resistance has been related to impaired myocardial MEEi, it is unknown the relationship between cardiac insulin resistance and MEEi. Aim of this study was to evaluate the relationship between insulin-stimulated myocardial glucose metabolic rate (MrGlu) and myocardial MEEi in subjects having different degrees of glucose tolerance. Methods We evaluated insulin-stimulated myocardial MrGlu using cardiac dynamic positron emission tomography (PET) with 18F-Fluorodeoxyglucose (18F-FDG) combined with euglycemic-hyperinsulinemic clamp, and myocardial MEEi in 57 individuals without history of coronary heart disease having different degrees of glucose tolerance. The subjects were stratified into tertiles according to their myocardial MrGlu values. Results After adjusting for age, gender and BMI, subjects in I tertile showed a decrease in myocardial MEEi (0.31 ± 0.05 vs 0.42 ± 0.14 ml/s*g, P = 0.02), and an increase in myocardial oxygen consumption (MVO2) (10,153 ± 1375 vs 7816 ± 1229 mmHg*bpm, P < 0.0001) as compared with subjects in III tertile. Univariate correlations showed that insulin-stimulated myocardial MrGlu was positively correlated with MEEi and whole-body glucose disposal, and negatively correlated with waist circumference, fasting plasma glucose, HbA1c and MVO2. In a multivariate regression analysis running a model including several CV risk factors, the only variable that remained significantly associated with MEEi was myocardial MrGlu (β 0.346; P = 0.01). Conclusions These data suggest that an impairment in insulin-stimulated myocardial glucose metabolism is an independent contributor of depressed myocardial MEEi in subjects without history of CHD.

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Section: Discussionmentioning

confidence: 99%

Impaired insulin-stimulated myocardial glucose metabolic rate is associated with reduced estimated myocardial energetic efficiency in subjects with different degrees of glucose tolerance

Succurro

Cicone

Papa

et al. 2023

Cardiovasc Diabetol

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“…This type of metabolic flexibility can be tested by imaging myocardial glucose uptake during insulin administration. Patients with type 2 diabetes with and without cardiac disease are characterized by myocardial insulin resistance. A consistent underlying factor is the excess of fatty acids in the circulation.…”

Section: Obesity‐related Complicationsmentioning

confidence: 99%

Metabolic imaging in obesity: underlying mechanisms and consequences in the whole body

Iozzo

2015

Annals of the New York Academy of Sciences

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Obesity is a phenotype resulting from a series of causative factors with a variable risk of complications. Etiologic diversity requires personalized prevention and treatment. Imaging procedures offer the potential to investigate the interplay between organs and pathways underlying energy intake and consumption in an integrated manner, and may open the perspective to classify and treat obesity according to causative mechanisms. This review illustrates the contribution provided by imaging studies to the understanding of human obesity, starting with the regulation of food intake and intestinal metabolism, followed by the role of adipose tissue in storing, releasing, and utilizing substrates, including the interconversion of white and brown fat, and concluding with the examination of imaging risk indicators related to complications, including type 2 diabetes, liver pathologies, cardiac and kidney diseases, and sleep disorders. The imaging modalities include (1) positron emission tomography to quantify organ-specific perfusion and substrate metabolism; (2) computed tomography to assess tissue density as an indicator of fat content and browning/ whitening; (3) ultrasounds to examine liver steatosis, stiffness, and inflammation; and (4) magnetic resonance techniques to assess blood oxygenation levels in the brain, liver stiffness, and metabolite contents (triglycerides, fatty acids, glucose, phosphocreatine, ATP, and acetylcarnitine) in a variety of organs.

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“…Insulin resistance appears to be a core factor contributing to impaired myocardial function in type 2 diabetes (T2D) [ 1 , 2 ]. Myocardial insulin resistance is specifically associated with T2D and is proportional to systemic insulin resistance and to left ventricular systolic dysfunction [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Dapagliflozin on Myocardial Insulin Sensitivity and Perfusion: Rationale and Design of The DAPAHEART Trial

et al. 2021

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Similar patterns of myocardial metabolism and perfusion in patients with type 2 diabetes and heart disease of ischaemic and non-ischaemic origin

Cited by 5 publications

References 28 publications

Impaired insulin-stimulated myocardial glucose metabolic rate is associated with reduced estimated myocardial energetic efficiency in subjects with different degrees of glucose tolerance

Impaired insulin-stimulated myocardial glucose metabolic rate is associated with reduced estimated myocardial energetic efficiency in subjects with different degrees of glucose tolerance

Metabolic imaging in obesity: underlying mechanisms and consequences in the whole body

Effect of Dapagliflozin on Myocardial Insulin Sensitivity and Perfusion: Rationale and Design of The DAPAHEART Trial

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