{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T22:13:17Z","timestamp":1778364797302,"version":"3.51.4"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T00:00:00Z","timestamp":1590710400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T00:00:00Z","timestamp":1590710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81771887"],"award-info":[{"award-number":["81771887"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81471722"],"award-info":[{"award-number":["81471722"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81771897"],"award-info":[{"award-number":["81771897"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971586"],"award-info":[{"award-number":["81971586"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004602","name":"Program for New Century Excellent Talents in University","doi-asserted-by":"publisher","award":["NCET-13-0386"],"award-info":[{"award-number":["NCET-13-0386"]}],"id":[{"id":"10.13039\/501100004602","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Program for Young Scholars and Innovative Research Team in Sichuan Province of China","award":["2017TD0005"],"award-info":[{"award-number":["2017TD0005"]}]},{"name":"1\u00b73\u00b75 project for disciplines of excellence, West China Hospital, Sichuan University","award":["ZYGD18013"],"award-info":[{"award-number":["ZYGD18013"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Diabetol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that collectively cause an increased risk of type 2 diabetes mellitus (T2DM) and nonatherosclerotic cardiovascular disease. This study aimed to evaluate the role of myocardial steatosis in T2DM patients with or without MetS, as well as the relationship between subclinical left ventricular (LV) myocardial dysfunction and myocardial steatosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and materials<\/jats:title><jats:p>We recruited 53 T2DM patients and 20 healthy controls underwent cardiac magnetic resonance examination. All T2DM patients were subdivide into two group: MetS group and non-MetS. LV deformation, perfusion parameters and myocardial triglyceride (TG) content were measured and compared among these three groups. Pearson\u2019s and Spearman analysis were performed to investigate the correlation between LV cardiac parameters and myocardial steatosis. The receiver operating characteristic curve (ROC) was performed to illustrate the relationship between myocardial steatosis and LV subclinical myocardial dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An increase in myocardial TG content was found in the MetS group compared with that in the other groups (MetS vs. non-MetS: 1.54\u2009\u00b1\u20090.63% vs. 1.16\u2009\u00b1\u20090.45%; MetS vs. normal: 1.54\u2009\u00b1\u20090.63% vs. 0.61\u2009\u00b1\u20090.22%; all p\u2009&lt;\u20090.001). Furthermore, reduced LV deformation [reduced longitudinal and radial peak strain (PS); all p\u2009&lt;\u20090.017] and microvascular dysfunction [increased time to maximum signal intensity (TTM) and reduced Upslope; all p\u2009&lt;\u20090.017)] was found in the MetS group. Myocardial TG content was positively associated with MetS (r\u2009=\u20090.314, p\u2009&lt;\u20090.001), and it was independently associated with TTM (\u03b2\u2009=\u20090.441, p\u2009&lt;\u20090.001) and\u00a0LV longitudinal PS (\u03b2\u2009=\u20090.323, p\u2009=\u20090.021). ROC analysis exhibited that myocardial TG content might predict the risk of decreased LV longitudinal myocardial deformation (AUC\u2009=\u20090.74) and perfusion function (AUC\u2009=\u20090.71).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Myocardial TG content increased in T2DM patients with concurrent MetS. Myocardial steatosis was positively associated with decreased myocardial deformation and perfusion dysfunction, which may be an indicator for predicting diabetic cardiomyopathy.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12933-020-01044-1","type":"journal-article","created":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T16:03:52Z","timestamp":1590768232000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Metabolic syndrome and myocardium steatosis in subclinical type 2 diabetes mellitus: a 1H-magnetic resonance spectroscopy study"],"prefix":"10.1186","volume":"19","author":[{"given":"Yue","family":"Gao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-kun","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin-jun","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng-ting","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-yan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9341-7697","authenticated-orcid":false,"given":"Zhi-gang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,5,29]]},"reference":[{"issue":"1","key":"1044_CR1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12968-019-0551-6","volume":"21","author":"C Mauger","year":"2019","unstructured":"Mauger C, Gilbert K, Lee AM, et al. Right ventricular shape and function: cardiovascular magnetic resonance reference morphology and biventricular risk factor morphometrics in UK Biobank. J Cardiovasc Magn Reson. 2019;21(1):41.","journal-title":"J Cardiovasc Magn Reson"},{"issue":"4177","key":"1044_CR2","first-page":"652","volume":"187","author":"K Yoneyama","year":"2018","unstructured":"Yoneyama K, Venkatesh BA, Wu CO, Mewton N, Gjesdal O, Kishi S, McClelland RL, Bluemke DA, Lima JA. 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;187(4177):652\u20133.","journal-title":"J Cardiovasc Magn Reson"},{"issue":"4","key":"1044_CR3","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1002\/jmri.22879","volume":"35","author":"G Korosoglou","year":"2012","unstructured":"Korosoglou G, Humpert PM, Ahrens J, et al. Left ventricular diastolic function in type 2 diabetes mellitus is associated with myocardial triglyceride content but not with impaired myocardial perfusion reserve. J Magn Reson Imaging. 2012;35(4):804\u201311.","journal-title":"J Magn Reson Imaging"},{"key":"1044_CR4","doi-asserted-by":"publisher","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","volume":"112","author":"SM Grundy","year":"2006","unstructured":"Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and Management of the Metabolic Syndrome An American Heart Association\/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2006;112:2735\u201352.","journal-title":"Circulation"},{"issue":"1","key":"1044_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/obr.12229","volume":"16","author":"S O\u2019Neill","year":"2015","unstructured":"O\u2019Neill S, O\u2019Driscoll L. Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies. Obes Rev. 2015;16(1):1\u201312.","journal-title":"Obes Rev"},{"issue":"1","key":"1044_CR6","first-page":"25","volume":"8","author":"R Yogita","year":"2018","unstructured":"Yogita R, Pothineni SK. Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Ther Adv Vaccines. 2018;8(1):25\u201332.","journal-title":"Ther Adv Vaccines."},{"issue":"1","key":"1044_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1532-429X-15-103","volume":"15","author":"K Nyman","year":"2013","unstructured":"Nyman K, Gran\u00e9r M, Pentik\u00e4inen MO, et al. Cardiac steatosis and left ventricular function in men with metabolic syndrome. J Cardiovasc Magn Reson. 2013;15(1):1\u201311.","journal-title":"J Cardiovasc Magn Reson"},{"issue":"1","key":"1044_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12933-017-0656-x","volume":"17","author":"Xi Liu","year":"2018","unstructured":"Liu Xi, Yang Zhi-gang, Gao Yue, et al. Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: a contrast-enhanced cardiovascular magnetic resonance study. Cardiovasc Diabetol. 2018;17(1):1\u201312.","journal-title":"Cardiovasc Diabetol."},{"issue":"2","key":"1044_CR9","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1148\/radiol.2017170529","volume":"286","author":"S Romano","year":"2018","unstructured":"Romano S, Judd RM, Kim RJ, et al. Left Ventricular Long-Axis Function Assessed with Cardiac Cine MR Imaging Is an Independent Predictor of All-Cause Mortality in Patients with Reduced Ejection Fraction: a Multicenter Study. Radiology. 2018;286(2):452\u201360.","journal-title":"Radiology"},{"issue":"2","key":"1044_CR10","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1148\/radiol.2018172613","volume":"288","author":"GR Karur","year":"2018","unstructured":"Karur GR, Robison S, Iwanochko RM, et al. Use of myocardial T1 mapping at 30 T to differentiate anderson-fabry disease from hypertrophic cardiomyopathy. Radiology. 2018;288(2):398\u2013406.","journal-title":"Radiology"},{"issue":"7","key":"1044_CR11","doi-asserted-by":"publisher","first-page":"3105","DOI":"10.1007\/s00330-017-5185-1","volume":"28","author":"H Patscheider","year":"2018","unstructured":"Patscheider H, Lorbeer R, Auweter S, et al. Subclinical changes in MRI-determined right ventricular volumes and function in subjects with prediabetes and diabetes. Eur Radiol. 2018;28(7):3105\u201313.","journal-title":"Eur Radiol"},{"issue":"12","key":"1044_CR12","doi-asserted-by":"publisher","first-page":"6846","DOI":"10.1007\/s00330-019-06315-4","volume":"29","author":"M Dobrovie","year":"2019","unstructured":"Dobrovie M, Barreiro-Perez M, Curione D, et al. Inter-vendor reproducibility and accuracy of segmental left ventricular strain measurements using CMR feature tracking. Eur Radiol. 2019;29(12):6846\u201357.","journal-title":"Eur Radiol"},{"issue":"1","key":"1044_CR13","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s12968-018-0448-9","volume":"20","author":"JJ Cao","year":"2018","unstructured":"Cao JJ, Ngai N, Duncanson L, et al. A comparison of both DENSE and feature tracking techniques with tagging for the cardiovascular magnetic resonance assessment of myocardial strain. J Cardiovasc Magn Reson. 2018;20(1):26.","journal-title":"J Cardiovasc Magn Reson"},{"issue":"7","key":"1044_CR14","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1002\/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S","volume":"15","author":"KG Alberti","year":"1998","unstructured":"Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15(7):539\u201353.","journal-title":"Diabet Med"},{"key":"1044_CR15","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1016\/S0140-6736(05)67402-8","volume":"366","author":"A Kgmm","year":"2005","unstructured":"Kgmm A, Pz Z, Shaw J. The metabolic syndrome\u2014a new worldwide definition from the international diabetesis federation consensus. Lancet. 2005;366:1059\u201362.","journal-title":"Lancet"},{"issue":"1","key":"1044_CR16","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.jacc.2016.03.597","volume":"68","author":"E Levelt","year":"2016","unstructured":"Levelt E, Pavlides M, Banerjee R, et al. Ectopic and visceral fat deposition in lean and obese patients with type 2 diabetes. J Am Coll Cardiol. 2016;68(1):53\u201363.","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"1044_CR17","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1148\/radiol.2017170760","volume":"287","author":"L Hu","year":"2018","unstructured":"Hu L, Zha YF, Wang L, et al. Quantitative evaluation of vertebral microvascular permeability and fat fraction in alloxan-induced diabetic rabbits. Radiology. 2018;287(1):128\u201336.","journal-title":"Radiology"},{"key":"1044_CR18","doi-asserted-by":"publisher","first-page":"2538","DOI":"10.1161\/CIRCULATIONAHA.110.955542","volume":"122","author":"AC Ngdf","year":"2010","unstructured":"Ngdf AC, Delgado V, Bertini M, et al. Myocardial steatosis and biventricular strain and strain rate imaging in patients with type 2 diabetes mellitus. Circulation. 2010;122:2538\u201344.","journal-title":"Circulation"},{"issue":"3","key":"1044_CR19","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.numecd.2009.08.011","volume":"20","author":"P Iozzo","year":"2010","unstructured":"Iozzo P. Metabolic toxicity of the heart: insights from molecular imaging. Nutr Metab Cardiovasc Dis. 2010;20(3):147\u201356.","journal-title":"Nutr Metab Cardiovasc Dis."},{"issue":"4","key":"1044_CR20","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/j.ejheart.2004.07.014","volume":"7","author":"D Vinereanu","year":"2005","unstructured":"Vinereanu D, Lim PO, Frenneaux MP, et al. Reduced myocardial velocities of left ventricular long-axis contraction identify both systolic and diastolic heart failure\u2014a comparison with brain natriuretic peptide. Eur J Heart Fail. 2005;7(4):512\u20139.","journal-title":"Eur J Heart Fail"},{"issue":"1","key":"1044_CR21","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s12933-018-0755-3","volume":"17","author":"J Murai","year":"2018","unstructured":"Murai J, Nishizawa H, Otsuka A, et al. Low muscle quality in Japanese type 2 diabetic patients with visceral fat accumulation. Cardiovasc Diabetol. 2018;17(1):112.","journal-title":"Cardiovasc Diabetol."},{"issue":"1","key":"1044_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12933-017-0496-8","volume":"16","author":"EA Hulten","year":"2017","unstructured":"Hulten EA, Bittencourt MS, Preston R, et al. Obesity, metabolic syndrome and cardiovascular prognosis: from the Partners coronary computed tomography angiography registry. Cardiovasc Diabetol. 2017;16(1):1\u201311.","journal-title":"Cardiovasc Diabetol."},{"issue":"1","key":"1044_CR23","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s12933-019-0862-9","volume":"18","author":"C Mancusi","year":"2019","unstructured":"Mancusi C, de Simone G, Best LG, et al. Myocardial mechano-energetic efficiency and insulin resistance in non-diabetic members of the Strong Heart Study cohort. Cardiovasc Diabetol. 2019;18(1):56.","journal-title":"Cardiovasc Diabetol."},{"issue":"6","key":"1044_CR24","doi-asserted-by":"publisher","first-page":"3027","DOI":"10.1007\/s00330-018-5793-4","volume":"29","author":"C Klein","year":"2019","unstructured":"Klein C, Brunereau J, Lacroix D, et al. Left atrial epicardial adipose tissue radiodensity is associated with electrophysiological properties of atrial myocardium in patients with atrial fibrillation. Eur Radiol. 2019;29(6):3027\u201335.","journal-title":"Eur Radiol"},{"issue":"3","key":"1044_CR25","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1210\/jc.2012-3190","volume":"98","author":"M Gran\u00e9r","year":"2013","unstructured":"Gran\u00e9r M, Siren R, Nyman K, et al. Cardiac steatosis associates with visceral obesity in nondiabetic obese men. J Clin Endocrinol Metab. 2013;98(3):1189\u201397.","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"1044_CR26","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1161\/CIRCULATIONAHA.107.763730","volume":"118","author":"BI Levy","year":"2008","unstructured":"Levy BI, Schiffrin EL, Mourad JJ, et al. Impaired tissue perfusion a pathology common to hypertension, obesity, and diabetes mellitus. Circulation. 2008;118(9):968\u201376.","journal-title":"Circulation"},{"issue":"3","key":"1044_CR27","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1097\/HJH.0b013e32834f6f3f","volume":"30","author":"D Mandry","year":"2012","unstructured":"Mandry D, Eschalier R, Kearney-Schwartz A, et al. Comprehensive MRI analysis of early cardiac and vascular remodeling in middle-aged patients with abdominal obesity. J Hypertens. 2012;30(3):567\u201373.","journal-title":"J Hypertens"},{"issue":"1","key":"1044_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12933-019-0917-y","volume":"18","author":"RH Christensen","year":"2019","unstructured":"Christensen RH, von Scholten BJ, Hansen CS, et al. Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes. Cardiovasc Diabetol. 2019;18(1):1\u201310.","journal-title":"Cardiovasc Diabetol."},{"issue":"5","key":"1044_CR29","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.numecd.2016.03.012","volume":"26","author":"P Wolf","year":"2016","unstructured":"Wolf P, Winhofer Y, Krssak M, et al. Suppression of plasma free fatty acids reduces myocardial lipid content and systolic function in type 2 diabetes. Nutr Metab Cardiovasc Dis. 2016;26(5):387\u201392.","journal-title":"Nutr Metab Cardiovasc Dis."},{"issue":"5","key":"1044_CR30","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1002\/jmri.25718","volume":"46","author":"T Chitiboi","year":"2017","unstructured":"Chitiboi T, Axel L. Magnetic resonance imaging of myocardial strain: a review of current approaches. J Magn Reson Imaging. 2017;46(5):1263\u201380.","journal-title":"J Magn Reson Imaging"},{"key":"1044_CR31","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.diabres.2019.03.004","volume":"150","author":"Y Gao","year":"2019","unstructured":"Gao Y, Yang Z, Ren Y, et al. Evaluation myocardial fibrosis in diabetes with cardiac magnetic resonance T1-mapping: correlation with the high-level hemoglobin A1c. Diabetes Res Clin Pract. 2019;150:72\u201380.","journal-title":"Diabetes Res Clin Pract"},{"issue":"1","key":"1044_CR32","doi-asserted-by":"publisher","first-page":"H14","DOI":"10.1152\/ajpheart.00612.2015","volume":"310","author":"J Wei","year":"2016","unstructured":"Wei J, Nelson MD, Szczepaniak EW, et al. Myocardial steatosis as a possible mechanistic link between diastolic dysfunction and coronary microvascular dysfunction in women. Am J Physiol Hear Circ Physiol. 2016;310(1):H14\u20139.","journal-title":"Am J Physiol Hear Circ Physiol."},{"issue":"22","key":"1044_CR33","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.1016\/j.jacc.2008.07.062","volume":"52","author":"LJ Rijzewijk","year":"2008","unstructured":"Rijzewijk LJ, van der Meer RW, Smit JWA, et al. Myocardial steatosis is an independent predictor of diastolic dysfunction in type 2 diabetes mellitus. J Am Coll Cardiol. 2008;52(22):1793\u20139.","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"1044_CR34","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1038\/ijo.2015.151","volume":"40","author":"R Dobson","year":"2016","unstructured":"Dobson R, Burgess MI, Sprung VS, et al. Metabolically healthy and unhealthy obesity: differential effects on myocardial function according to metabolic syndrome, rather than obesity. Int J Obes. 2016;40(1):153\u201361.","journal-title":"Int J Obes."},{"issue":"1","key":"1044_CR35","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1093\/cvr\/cvr212","volume":"92","author":"T van de Weijer","year":"2011","unstructured":"van de Weijer T, Schrauwen-Hinderling VB, Schrauwen P. Lipotoxicity in type 2 diabetic cardiomyopathy. Cardiovasc Res. 2011;92(1):10\u20138.","journal-title":"Cardiovasc Res"},{"issue":"5","key":"1044_CR36","doi-asserted-by":"publisher","first-page":"177","DOI":"10.4239\/wjd.v4.i5.177","volume":"4","author":"JM Pappachan","year":"2017","unstructured":"Pappachan JM, Varughese GI, Sriraman R, Arunagirinathan G. Diabetic cardiomyopathy: pathophysiology, diagnostic evaluation and management. World J Diabetes. 2017;4(5):177.","journal-title":"World J Diabetes."},{"issue":"1","key":"1044_CR37","doi-asserted-by":"crossref","first-page":"44","DOI":"10.2337\/db15-0627","volume":"65","author":"E Levelt","year":"2016","unstructured":"Levelt E, Mahmod M, Piechnik SK, et al. Relationship between left ventricular structural and metabolic remodeling in type 2 diabetes. Diabetes. 2016;65(1):44\u201352.","journal-title":"Diabetes"},{"issue":"1","key":"1044_CR38","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12968-018-0511-6","volume":"20","author":"M Mahmod","year":"2018","unstructured":"Mahmod M, Pal N, Rayner J, et al. The interplay between metabolic alterations, diastolic strain rate and exercise capacity in mild heart failure with preserved ejection fraction: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2018;20(1):88.","journal-title":"J Cardiovasc Magn Reson"},{"issue":"4","key":"1044_CR39","doi-asserted-by":"publisher","first-page":"R127","DOI":"10.1530\/EJE-17-0724","volume":"178","author":"E Levelt","year":"2018","unstructured":"Levelt E, Gulsin G, Neubauer S, McCann GP. Diabetic cardiomyopathy: pathophysiology and potential metabolic interventions state of the art review. Eur J Endocrinol. 2018;178(4):R127\u201339.","journal-title":"Eur J Endocrinol"}],"container-title":["Cardiovascular Diabetology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12933-020-01044-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12933-020-01044-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12933-020-01044-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T18:09:52Z","timestamp":1666721392000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiab.biomedcentral.com\/articles\/10.1186\/s12933-020-01044-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,29]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1044"],"URL":"https:\/\/doi.org\/10.1186\/s12933-020-01044-1","relation":{},"ISSN":["1475-2840"],"issn-type":[{"value":"1475-2840","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,29]]},"assertion":[{"value":"22 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study complied with the Declaration of Helsinki and was approved by the West-China hospital of Sichuan University biomedical research ethics committee (Chengdu, Sichuan, China; No. 2016-24). Written informed consents were obtained from all the study participants.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there are no conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"70"}}