{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:44:38Z","timestamp":1791179078228,"version":"4.1.0"},"reference-count":43,"publisher":"American Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2016,7,1]],"date-time":"2016-07-01T00:00:00Z","timestamp":1467331200000},"content-version":"vor","delay-in-days":270,"URL":"http:\/\/www.diabetesjournals.org\/site\/license"}],"funder":[{"DOI":"10.13039\/501100005617","name":"BHF Centre of Research Excellence, Oxford","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005617","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["098436\/Z\/12\/Z"],"award-info":[{"award-number":["098436\/Z\/12\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:p>Concentric left ventricular (LV) remodeling is associated with adverse cardiovascular events and is frequently observed in patients with type 2 diabetes mellitus (T2DM). Despite this, the cause of concentric remodeling in diabetes per se is unclear, but it may be related to cardiac steatosis and impaired myocardial energetics. Thus, we investigated the relationship between myocardial metabolic changes and LV remodeling in T2DM. Forty-six nonhypertensive patients with T2DM and 20 matched control subjects underwent cardiovascular magnetic resonance to assess LV remodeling (LV mass\u2013to\u2013LV end diastolic volume ratio), function, tissue characterization before and after contrast using T1 mapping, and 1H and 31P magnetic resonance spectroscopy for myocardial triglyceride content (MTG) and phosphocreatine-to-ATP ratio, respectively. When compared with BMI- and blood pressure\u2013matched control subjects, subjects with diabetes were associated with concentric LV remodeling, higher MTG, impaired myocardial energetics, and impaired systolic strain indicating a subtle contractile dysfunction. Importantly, cardiac steatosis independently predicted concentric remodeling and systolic strain. Extracellular volume fraction was unchanged, indicating the absence of fibrosis. In conclusion, cardiac steatosis may contribute to concentric remodeling and contractile dysfunction of the LV in diabetes. Because cardiac steatosis is modifiable, strategies aimed at reducing MTG may be beneficial in reversing concentric remodeling and improving contractile function in the hearts of patients with diabetes.<\/jats:p>","DOI":"10.2337\/db15-0627","type":"journal-article","created":{"date-parts":[[2015,10,6]],"date-time":"2015-10-06T02:58:18Z","timestamp":1444100298000},"page":"44-52","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":226,"title":["Relationship Between Left Ventricular Structural and Metabolic Remodeling in Type 2 Diabetes"],"prefix":"10.2337","volume":"65","author":[{"given":"Eylem","family":"Levelt","sequence":"first","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."},{"name":"Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masliza","family":"Mahmod","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan K.","family":"Piechnik","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Ariga","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane M.","family":"Francis","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher T.","family":"Rodgers","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikant","family":"Sabharwal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, John Radcliffe Hospital, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurgen E.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros D.","family":"Karamitsos","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."},{"name":"First Department of Cardiology, Aristotle University, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver J.","family":"Rider","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Neubauer","sequence":"additional","affiliation":[{"name":"Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2015,10,5]]},"reference":[{"key":"2022031300415851900_B1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2337\/diab.23.2.105","article-title":"Morbidity and mortality in diabetics in the Framingham population. Sixteen year follow-up study","volume":"23","author":"Garcia","year":"1974","journal-title":"Diabetes"},{"key":"2022031300415851900_B2","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1001\/jama.1979.03290450033020","article-title":"Diabetes and cardiovascular disease. The Framingham study","volume":"241","author":"Kannel","year":"1979","journal-title":"JAMA"},{"key":"2022031300415851900_B3","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1161\/01.CIR.101.19.2271","article-title":"Impact of diabetes on cardiac structure and function: the strong heart study","volume":"101","author":"Devereux","year":"2000","journal-title":"Circulation"},{"key":"2022031300415851900_B4","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/S0002-9149(01)01516-8","article-title":"Separate and joint effects of systemic hypertension and diabetes mellitus on left ventricular structure and function in American Indians (the Strong Heart Study)","volume":"87","author":"Bella","year":"2001","journal-title":"Am J Cardiol"},{"key":"2022031300415851900_B5","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1038\/nrcardio.2011.154","article-title":"Cardiac remodeling at the population level--risk factors, screening, and outcomes","volume":"8","author":"Gjesdal","year":"2011","journal-title":"Nat Rev Cardiol"},{"key":"2022031300415851900_B6","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1016\/j.jacc.2008.09.014","article-title":"The relationship of left ventricular mass and geometry to incident cardiovascular events: the MESA (Multi-Ethnic Study of Atherosclerosis) Study","volume":"52","author":"Bluemke","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2022031300415851900_B7","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1532-429X-14-50","article-title":"Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance","volume":"14","author":"Dweck","year":"2012","journal-title":"J Cardiovasc Magn Reson"},{"key":"2022031300415851900_B8","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.abb.2014.11.009","article-title":"Downregulation of adipose triglyceride lipase promotes cardiomyocyte hypertrophy by triggering the accumulation of ceramides","volume":"565","author":"Gao","year":"2015","journal-title":"Arch Biochem Biophys"},{"key":"2022031300415851900_B9","doi-asserted-by":"crossref","first-page":"H339","DOI":"10.1152\/ajpheart.00742.2014","article-title":"Cardiac steatosis potentiates angiotensin II effects in the heart","volume":"308","author":"Glenn","year":"2015","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2022031300415851900_B10","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1161\/HYPERTENSIONAHA.110.160655","article-title":"A murine model of isolated cardiac steatosis leads to cardiomyopathy","volume":"57","author":"Glenn","year":"2011","journal-title":"Hypertension"},{"key":"2022031300415851900_B11","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1002\/mrm.10372","article-title":"Myocardial triglycerides and systolic function in humans: in vivo evaluation by localized proton spectroscopy and cardiac imaging","volume":"49","author":"Szczepaniak","year":"2003","journal-title":"Magn Reson Med"},{"key":"2022031300415851900_B12","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.amjcard.2013.05.036","article-title":"Cardiac steatosis and left ventricular hypertrophy in patients with generalized lipodystrophy as determined by magnetic resonance spectroscopy and imaging","volume":"112","author":"Nelson","year":"2013","journal-title":"Am J Cardiol"},{"key":"2022031300415851900_B13","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1161\/CIRCULATIONAHA.106.645614","article-title":"Cardiac steatosis in diabetes mellitus: a 1H-magnetic resonance spectroscopy study","volume":"116","author":"McGavock","year":"2007","journal-title":"Circulation"},{"key":"2022031300415851900_B14","doi-asserted-by":"crossref","first-page":"3040","DOI":"10.1161\/01.CIR.0000072789.89096.10","article-title":"Abnormal cardiac and skeletal muscle energy metabolism in patients with type 2 diabetes","volume":"107","author":"Scheuermann-Freestone","year":"2003","journal-title":"Circulation"},{"key":"2022031300415851900_B15","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1161\/01.CIR.96.7.2190","article-title":"Myocardial phosphocreatine-to-ATP ratio is a predictor of mortality in patients with dilated cardiomyopathy","volume":"96","author":"Neubauer","year":"1997","journal-title":"Circulation"},{"key":"2022031300415851900_B16","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1161\/01.CIR.83.6.1849","article-title":"Pathological hypertrophy and cardiac interstitium. Fibrosis and renin-angiotensin-aldosterone system","volume":"83","author":"Weber","year":"1991","journal-title":"Circulation"},{"key":"2022031300415851900_B17","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/0002-9149(72)90595-4","article-title":"New type of cardiomyopathy associated with diabetic glomerulosclerosis","volume":"30","author":"Rubler","year":"1972","journal-title":"Am J Cardiol"},{"key":"2022031300415851900_B18","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1161\/CIRCULATIONAHA.107.728550","article-title":"Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension","volume":"117","author":"van Heerebeek","year":"2008","journal-title":"Circulation"},{"key":"2022031300415851900_B19","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.jcmg.2013.01.011","article-title":"T1 mapping for myocardial extracellular volume measurement by CMR: bolus only versus primed infusion technique","volume":"6","author":"White","year":"2013","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022031300415851900_B20","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/1532-429X-14-90","article-title":"Diffuse myocardial fibrosis evaluation using cardiac magnetic resonance T1 mapping: sample size considerations for clinical trials","volume":"14","author":"Liu","year":"2012","journal-title":"J Cardiovasc Magn Reson"},{"key":"2022031300415851900_B21","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S","article-title":"Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation","volume":"15","author":"Alberti","year":"1998","journal-title":"Diabet Med"},{"key":"2022031300415851900_B22","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.1038\/oby.2010.64","article-title":"The effect of obesity and weight loss on aortic pulse wave velocity as assessed by magnetic resonance imaging","volume":"18","author":"Rider","year":"2010","journal-title":"Obesity (Silver Spring)"},{"key":"2022031300415851900_B23","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.2337\/dc07-S004","article-title":"Standards of medical care in diabetes--2007","volume":"30","author":"American Diabetes Association","year":"2007","journal-title":"Diabetes Care"},{"key":"2022031300415851900_B24","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.jcct.2009.03.004","article-title":"SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee","volume":"3","author":"Abbara","year":"2009","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2022031300415851900_B25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2008.11.029","article-title":"Echocardiographic assessment of valve stenosis: EAE\/ASE recommendations for clinical practice","volume":"22","author":"Baumgartner","year":"2009","journal-title":"J Am Soc Echocardiogr"},{"key":"2022031300415851900_B26","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/eurheartj\/ehs341","article-title":"Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging","volume":"34","author":"Rider","year":"2013","journal-title":"Eur Heart J"},{"key":"2022031300415851900_B27","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/1475-925X-10-76","article-title":"Magnetic resonance imaging detects significant sex differences in human myocardial strain","volume":"10","author":"Lawton","year":"2011","journal-title":"Biomed Eng Online"},{"key":"2022031300415851900_B28","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/BF02634597","article-title":"Single breath-hold slice-following CSPAMM myocardial tagging","volume":"9","author":"Stuber","year":"1999","journal-title":"MAGMA"},{"key":"2022031300415851900_B29","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1532-429X-12-69","article-title":"Shortened Modified Look-Locker Inversion recovery (ShMOLLI) for clinical myocardial T1-mapping at 1.5 and 3 T within a 9 heartbeat breathhold","volume":"12","author":"Piechnik","year":"2010","journal-title":"J Cardiovasc Magn Reson"},{"key":"2022031300415851900_B30","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1161\/CIRCULATIONAHA.109.930636","article-title":"Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans","volume":"122","author":"Flett","year":"2010","journal-title":"Circulation"},{"key":"2022031300415851900_B31","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1532-429X-16-21","article-title":"Subclinical myocardial inflammation and diffuse fibrosis are common in systemic sclerosis--a clinical study using myocardial T1-mapping and extracellular volume quantification","volume":"16","author":"Ntusi","year":"2014","journal-title":"J Cardiovasc Magn Reson"},{"key":"2022031300415851900_B32","first-page":"2885","volume-title":"Linewidth constraints in Matlab AMARES using per-metabolite T2 and per-voxel \u0394B0","author":"Purvis","year":"2014"},{"key":"2022031300415851900_B33","first-page":"619","article-title":"Rapid quantification of myocardial lipid content in humans using single breath-hold 1H MRS at 3 Tesla","volume-title":"Magn Reson Med","author":"Rial","year":"2011"},{"key":"2022031300415851900_B34","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S0002-9149(96)00256-1","article-title":"Prognostic value of left ventricular mass and geometry in systemic hypertension with left ventricular hypertrophy","volume":"78","author":"Verdecchia","year":"1996","journal-title":"Am J Cardiol"},{"key":"2022031300415851900_B35","first-page":"984","article-title":"Left ventricular concentric remodeling is associated with decreased global and regional systolic function: the Multi-Ethnic Study of Atherosclerosis","volume":"112","author":"Rosen","year":"2005","journal-title":"Circulation"},{"key":"2022031300415851900_B36","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1161\/CIRCULATIONAHA.109.873273","article-title":"Relationship between coronary microvascular dysfunction and cardiac energetics impairment in type 1 diabetes mellitus","volume":"121","author":"Shivu","year":"2010","journal-title":"Circulation"},{"key":"2022031300415851900_B37","doi-asserted-by":"crossref","first-page":"H295","DOI":"10.1152\/ajpheart.00990.2012","article-title":"Glucagon-like peptide-1 receptor activation reverses cardiac remodeling via normalizing cardiac steatosis and oxidative stress in type 2 diabetes","volume":"305","author":"Monji","year":"2013","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2022031300415851900_B38","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1186\/1475-2840-12-172","article-title":"Eplerenone attenuated cardiac steatosis, apoptosis and diastolic dysfunction in experimental type-II diabetes","volume":"12","author":"Ram\u00edrez","year":"2013","journal-title":"Cardiovasc Diabetol"},{"key":"2022031300415851900_B39","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1007\/BF02374495","article-title":"Prognostic value of urinary albumin excretion rate and other risk factors in elderly diabetic patients and non-diabetic control subjects surviving the first 5 years after assessment","volume":"36","author":"Damsgaard","year":"1993","journal-title":"Diabetologia"},{"key":"2022031300415851900_B40","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jcmg.2009.10.012","article-title":"The impact of obesity on the left ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"3","author":"Turkbey","year":"2010","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022031300415851900_B41","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1172\/JCI0214080","article-title":"The cardiac phenotype induced by PPARalpha overexpression mimics that caused by diabetes mellitus","volume":"109","author":"Finck","year":"2002","journal-title":"J Clin Invest"},{"key":"2022031300415851900_B42","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1016\/S0140-6736(07)60242-6","article-title":"Renin-angiotensin system and cardiovascular risk","volume":"369","author":"Schmieder","year":"2007","journal-title":"Lancet"},{"key":"2022031300415851900_B43","doi-asserted-by":"crossref","first-page":"3213","DOI":"10.1161\/CIRCULATIONAHA.106.679597","article-title":"Diabetic cardiomyopathy revisited","volume":"115","author":"Boudina","year":"2007","journal-title":"Circulation"}],"container-title":["Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.org\/diabetes\/diabetes\/article-pdf\/65\/1\/44\/578657\/db150627.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article-pdf\/65\/1\/44\/578657\/db150627.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T16:47:31Z","timestamp":1667407651000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article\/65\/1\/44\/34906\/Relationship-Between-Left-Ventricular-Structural"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,5]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,10,5]]},"published-print":{"date-parts":[[2016,1,1]]}},"URL":"https:\/\/doi.org\/10.2337\/db15-0627","relation":{},"ISSN":["0012-1797","1939-327X"],"issn-type":[{"value":"0012-1797","type":"print"},{"value":"1939-327X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,5]]}}}