Helene Nørrelund

Failing Heart of Patients with Type 2 Diabetes Mellitus Can Adapt to Extreme Short-Term Increases in Circulating Lipids and Does Not Display Features of Acute Myocardial Lipotoxicity

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BACKGROUND: -Circulating lipid levels and myocardial lipid content (MyLC) is increased in type 2 diabetes (T2D). This may cause a state of lipotoxicity that compromises left ventricular function and aggravate heart failure. We investigated the relationship between circulating lipid levels, MyLC, and cardiac function together with the acute cardiac effects of high as opposed to low circulating free fatty acid (FFA) and triglyceride (TG) levels in patients with T2D and heart failure. METHODS AND RESULTS: -Eighteen patients underwent 8-hour intralipid/heparin-infusion (high-FFA) and hyperinsulinemic-euglycemic clamping (low-FFA) in a randomized cross-over-designed study. We applied MR-proton-spectroscopy to measure MyLC. Cardiac function was assessed by advanced echocardiography, cardiopulmonary exercise, and MR imaging. MyLC correlated positively with circulating TG (r=0.47, r(2)=0.22, p=0.003) and FFA (r=0.45, r(2)=0.20, p=0.001) levels and inversely with left ventricular ejection fraction (LVEF) (r=-0.54, r(2)=0.29, p=0.004). Circulating FFA concentrations differed between study arms (0.05±0.04mmol/L (low-FFA) vs 1.04±0.27mmol/L (high-FFA), p
TidsskriftCirculation. Heart Failure
Sider (fra-til)845-852
Antal sider8
StatusUdgivet - 16 jul. 2013

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