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 F-Fluorodeoxyglucose (F-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 (MVO) (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 MVO. 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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| http://dx.doi.org/10.1186/s12933-022-01733-z | DOI Listing |
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Article Synopsis
- The study investigates the link between plasma levels of asymmetric dimethylarginine (ADMA) and myocardial mechano-energetics efficiency (MEEi) in drug-naïve hypertensive individuals.
- It involved 63 hypertensive participants who had their myocardial MEEi measured through echocardiograms, while ADMA levels were analyzed using high-performance liquid chromatography.
- Results showed a significant negative association between ADMA levels and MEEi, suggesting that higher ADMA may reduce nitric oxide availability and thus lower myocardial efficiency, independent of other cardiovascular risk factors.
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