Imaging of pre-diabetic hearts could prevent cardiac failure

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Pre-diabetic patients amass lipids in cardiac myocytes, which is the early manifestation in type 2 diabetes mellitus and evident in heart failures, according to a study published in the August issue of Circulation. The study found that the fat buildup can be viewed through an imaging procedure for preventive purposes.

The researchers stratified 134 individuals into one of four groups: lean normoglycemic; overweight and obese normoglycemic; impaired glucose tolerance; and type 2 diabetes mellitus. They used MR spectroscopy and cardiac MR imaging to quantify myocardial triglyceride content and left ventricular function, respectively.

Compared with lean subjects, myocardial triglyceride content was 2.3-fold higher in those with impaired glucose tolerance and 2.1-fold higher in those with type two diabetes mellitus. Left ventricular ejection fraction was normal and comparable across all groups.

The lipid overstorage in cardiac myocytes produces lipotoxic intermediates that cause apoptosis, which leads to heart failure. Lidia Szczepaniak, PhD, senior author and professor of internal medicine, and her colleagues detected fat accumulation in cells of the beating heart signal as a person lies in an ordinary MR.

The study was conducted by researchers from University of Texas Southwestern Medical Center, Veterans Affairs Medical Center and Institute for Exercise and Environmental Medicine, Presbyterian Hospital, all located in Dallas.