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Oneglia AP, Szczepaniak LS, Zaha VG, Nelson MD. Myocardial steatosis across the spectrum of human health and disease. Exp Physiol 2024; 109:202-213. [PMID: 38063136 PMCID: PMC10841709 DOI: 10.1113/ep091566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/15/2023] [Indexed: 02/02/2024]
Abstract
Preclinical data strongly suggest that myocardial steatosis leads to adverse cardiac remodelling and left ventricular dysfunction. Using 1 H cardiac magnetic resonance spectroscopy, similar observations have been made across the spectrum of health and disease. The purpose of this brief review is to summarize these recent observations. We provide a brief overview of the determinants of myocardial triglyceride accumulation, summarize the current evidence that myocardial steatosis contributes to cardiac dysfunction, and identify opportunities for further research.
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Affiliation(s)
- Andrew P. Oneglia
- Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, College of Nursing and Health InnovationUniversity of Texas at ArlingtonArlingtonTexasUSA
| | | | - Vlad G. Zaha
- Division of Cardiology, Internal MedicineUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Advanced Imaging Research CenterUniversity of Texas Southwestern Medical CenterArlingtonTexasUSA
| | - Michael D. Nelson
- Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, College of Nursing and Health InnovationUniversity of Texas at ArlingtonArlingtonTexasUSA
- Clinical Imaging Research CenterUniversity of Texas at ArlingtonArlingtonTexasUSA
- Center for Healthy Living and LongevityUniversity of Texas at ArlingtonArlingtonTexasUSA
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Soghomonian A, Gaborit B, Carbone F, Castinetti F, Dutour A. Editorial: Cardiac fat in metabolic and endocrine diseases. Front Endocrinol (Lausanne) 2023; 14:1271565. [PMID: 37727453 PMCID: PMC10506075 DOI: 10.3389/fendo.2023.1271565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/16/2023] [Indexed: 09/21/2023] Open
Affiliation(s)
- Astrid Soghomonian
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, AP-HM, Marseille, France
| | - Bénédicte Gaborit
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, AP-HM, Marseille, France
| | - Federico Carbone
- First Clinic of internal Medicine, Department of Internal Medicine, University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova – Italian Cardiovascular Network, Genova, Italy
| | - Frédéric Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares Hypophysaires HYPO, AP-HM, Marseille, France
| | - Anne Dutour
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, AP-HM, Marseille, France
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Soghomonian A, Dutour A, Kachenoura N, Thuny F, Lasbleiz A, Ancel P, Cristofari R, Jouve E, Simeoni U, Kober F, Bernard M, Gaborit B. Is increased myocardial triglyceride content associated with early changes in left ventricular function? A 1H-MRS and MRI strain study. Front Endocrinol (Lausanne) 2023; 14:1181452. [PMID: 37424866 PMCID: PMC10323751 DOI: 10.3389/fendo.2023.1181452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Background Type 2 diabetes (T2D) and obesity induce left ventricular (LV) dysfunction. The underlying pathophysiological mechanisms remain unclear, but myocardial triglyceride content (MTGC) could be involved. Objectives This study aimed to determine which clinical and biological factors are associated with increased MTGC and to establish whether MTGC is associated with early changes in LV function. Methods A retrospective study was conducted using five previous prospective cohorts, leading to 338 subjects studied, including 208 well-phenotyped healthy volunteers and 130 subjects living with T2D and/or obesity. All the subjects underwent proton magnetic resonance spectroscopy and feature tracking cardiac magnetic resonance imaging to measure myocardial strain. Results MTGC content increased with age, body mass index (BMI), waist circumference, T2D, obesity, hypertension, and dyslipidemia, but the only independent correlate found in multivariate analysis was BMI (p=0.01; R²=0.20). MTGC was correlated to LV diastolic dysfunction, notably with the global peak early diastolic circumferential strain rate (r=-0.17, p=0.003), the global peak late diastolic circumferential strain rate (r=0.40, p<0.0001) and global peak late diastolic longitudinal strain rate (r=0.24, p<0.0001). MTGC was also correlated to systolic dysfunction via end-systolic volume index (r=-0.34, p<0.0001) and stroke volume index (r=-0.31, p<0.0001), but not with longitudinal strain (r=0.009, p=0.88). Interestingly, the associations between MTGC and strain measures did not persist in multivariate analysis. Furthermore, MTGC was independently associated with LV end-systolic volume index (p=0.01, R²=0.29), LV end-diastolic volume index (p=0.04, R²=0.46), and LV mass (p=0.002, R²=0.58). Conclusions Predicting MTGC remains a challenge in routine clinical practice, as only BMI independently correlates with increased MTGC. MTGC may play a role in LV dysfunction but does not appear to be involved in the development of subclinical strain abnormalities.
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Affiliation(s)
- Astrid Soghomonian
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
| | - Anne Dutour
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
| | - Nadjia Kachenoura
- Sorbonne Université, INSERM, CNRS, Laboratoire d’Imagerie Biomédicale, Paris, France
| | - Franck Thuny
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Adele Lasbleiz
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
| | - Patricia Ancel
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
| | | | - Elisabeth Jouve
- UPCET, Clinical Pharmacology, Assistance-Publique Hôpitaux de Marseille, Marseille, France
| | - Umberto Simeoni
- Division of Pediatrics & DOHaD Laboratory, CHUV University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Frank Kober
- Aix-Marseille Université, CNRS, CRMBM, Marseille, France
| | | | - Bénédicte Gaborit
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
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Chang KF, Lin G, Huang PC, Juan YH, Wang CH, Tsai SY, Lin YC, Wu MT, Liao PA, Yang LY, Liu MH, Lin YC, Wang JJ, Ng KK, Ng SH. Left Ventricular Function and Myocardial Triglyceride Content on 3T Cardiac MR Predict Major Cardiovascular Adverse Events and Readmission in Patients Hospitalized with Acute Heart Failure. J Clin Med 2020; 9:jcm9010169. [PMID: 31936313 PMCID: PMC7019990 DOI: 10.3390/jcm9010169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/05/2020] [Accepted: 01/07/2020] [Indexed: 01/11/2023] Open
Abstract
Background: This prospective study was designed to investigate whether myocardial triglyceride (TG) content from proton magnetic resonance spectroscopy (MRS) and left ventricular (LV) function parameters from cardiovascular magnetic resonance imaging (CMR) can serve as imaging biomarkers in predicting future major cardiovascular adverse events (MACE) and readmission in patients who had been hospitalized for acute heart failure (HF). Methods: Patients who were discharged after hospitalization for acute HF were prospectively enrolled. On a 3.0 T MR scanner, myocardial TG contents were measured using MRS, and LV parameters (function and mass) were evaluated using cine. The occurrence of MACE and the HF-related readmission served as the endpoints. Independent predictors were identified using univariate and multivariable Cox proportional hazard regression analyses. Results: A total of 133 patients (mean age, 52.4 years) were enrolled. The mean duration of follow-up in surviving patients was 775 days. Baseline LV functional parameters—including ejection fraction, LV end-diastolic volume, LV end-diastolic volume index (LVEDVI), and LV end-systolic volume (p < 0.0001 for all), and myocardial mass (p = 0.010)—were significantly associated with MACE. Multivariable analysis revealed that LVEDVI was the independent predictor for MACE, while myocardial mass was the independent predictor for 3- and 12-month readmission. Myocardial TG content (lipid resonances δ 1.6 ppm) was significantly associated with readmission in patients with ischemic heart disease. Conclusions: LVEDVI and myocardial mass are potential imaging biomarkers that independently predict MACE and readmission, respectively, in patients discharged after hospitalization for acute HF. Myocardial TG predicts readmission in patients with a history of ischemic heart disease.
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Affiliation(s)
- Kuang-Fu Chang
- Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung 20401, Taiwan; (K.-F.C.); (Y.-C.L.)
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 33305, Taiwan; (G.L.); (P.-C.H.); (Y.-H.J.); (P.-A.L.); (Y.-C.L.); (J.-J.W.)
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 33305, Taiwan; (G.L.); (P.-C.H.); (Y.-H.J.); (P.-A.L.); (Y.-C.L.); (J.-J.W.)
- Imaging Core Lab, Institute for Radiological Research, Chang Gung University, Taoyuan 333, Taiwan
- Clinical Metabolomics Core Lab, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Pei-Ching Huang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 33305, Taiwan; (G.L.); (P.-C.H.); (Y.-H.J.); (P.-A.L.); (Y.-C.L.); (J.-J.W.)
| | - Yu-Hsiang Juan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 33305, Taiwan; (G.L.); (P.-C.H.); (Y.-H.J.); (P.-A.L.); (Y.-C.L.); (J.-J.W.)
| | - Chao-Hung Wang
- Department of Cardiology and Heart Failure Center, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (C.-H.W.); (M.-H.L.)
| | - Shang-Yueh Tsai
- Graduate Institute of Applied Physics, National Chengchi University, Taipei 11605, Taiwan;
| | - Yu-Ching Lin
- Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung 20401, Taiwan; (K.-F.C.); (Y.-C.L.)
| | - Ming-Ting Wu
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan;
| | - Pen-An Liao
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 33305, Taiwan; (G.L.); (P.-C.H.); (Y.-H.J.); (P.-A.L.); (Y.-C.L.); (J.-J.W.)
| | - Lan-Yan Yang
- Clinical Trial Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan;
| | - Min-Hui Liu
- Department of Cardiology and Heart Failure Center, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (C.-H.W.); (M.-H.L.)
| | - Yu-Chun Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 33305, Taiwan; (G.L.); (P.-C.H.); (Y.-H.J.); (P.-A.L.); (Y.-C.L.); (J.-J.W.)
- Imaging Core Lab, Institute for Radiological Research, Chang Gung University, Taoyuan 333, Taiwan
| | - Jiun-Jie Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 33305, Taiwan; (G.L.); (P.-C.H.); (Y.-H.J.); (P.-A.L.); (Y.-C.L.); (J.-J.W.)
- Imaging Core Lab, Institute for Radiological Research, Chang Gung University, Taoyuan 333, Taiwan
| | - Koon-Kwan Ng
- Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung 20401, Taiwan; (K.-F.C.); (Y.-C.L.)
- Correspondence: (K.-K.N.); (S.-H.N.); Tel.: +886-2431-3131 (ext. 2214) (K.-K.N.); +886-3328-1200 (ext. 2575) (S.-H.N.); Fax: +886-2433-2869 (K.-K.N.); +886-3397-1936 (S.-H.N.)
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 33305, Taiwan; (G.L.); (P.-C.H.); (Y.-H.J.); (P.-A.L.); (Y.-C.L.); (J.-J.W.)
- Correspondence: (K.-K.N.); (S.-H.N.); Tel.: +886-2431-3131 (ext. 2214) (K.-K.N.); +886-3328-1200 (ext. 2575) (S.-H.N.); Fax: +886-2433-2869 (K.-K.N.); +886-3397-1936 (S.-H.N.)
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Hannukainen JC, Lautamäki R, Pärkkä J, Strandberg M, Saunavaara V, Hurme S, Soinio M, Dadson P, Virtanen KA, Grönroos T, Forsback S, Salminen P, Iozzo P, Nuutila P. Reversibility of myocardial metabolism and remodelling in morbidly obese patients 6 months after bariatric surgery. Diabetes Obes Metab 2018; 20:963-973. [PMID: 29206339 PMCID: PMC5888194 DOI: 10.1111/dom.13183] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/15/2017] [Accepted: 11/30/2017] [Indexed: 01/14/2023]
Abstract
AIMS To study myocardial substrate uptake, structure and function, before and after bariatric surgery, to clarify the interaction between myocardial metabolism and cardiac remodelling in morbid obesity. METHODS We studied 46 obese patients (age 44 ± 10 years, body mass index [BMI] 42 ± 4 kg/m2 ), including 18 with type 2 diabetes (T2D) before and 6 months after bariatric surgery and 25 healthy age-matched control group subjects. Myocardial fasting free fatty acid uptake (MFAU) and insulin-stimulated myocardial glucose uptake (MGU) were measured using positron-emission tomography. Myocardial structure and function, and myocardial triglyceride content (MTGC) and intrathoracic fat were measured using magnetic resonance imaging and magnetic resonance spectroscopy. RESULTS The morbidly obese study participants, with or without T2D, had cardiac hypertrophy, impaired myocardial function and substrate metabolism compared with the control group. Surgery led to marked weight reduction and remission of T2D in most of the participants. Postoperatively, myocardial function and structure improved and myocardial substrate metabolism normalized. Intrathoracic fat, but not MTGC, was reduced. Before surgery, BMI and MFAU correlated with left ventricular hypertrophy, and BMI, age and intrathoracic fat mass were the main variables associated with cardiac function. The improvement in whole-body insulin sensitivity correlated positively with the increase in MGU and the decrease in MFAU. CONCLUSIONS In the present study, obesity and age, rather than myocardial substrate uptake, were the causes of cardiac remodelling in morbidly obese patients with or without T2D. Cardiac remodelling and impaired myocardial substrate metabolism are reversible after surgically induced weight loss and amelioration of T2D.
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Affiliation(s)
| | | | - Jussi Pärkkä
- Department of Clinical PhysiologyTurku University HospitalTurkuFinland
| | | | | | - Saija Hurme
- Department of BiostatisticsUniversity of TurkuTurkuFinland
| | - Minna Soinio
- Department of EndocrinologyTurku University HospitalTurkuFinland
| | | | | | - Tove Grönroos
- Turku PET CentreÅbo Akademi UniversityTurkuFinland
- MediCity Research LaboratoryUniversity of TurkuTurkuFinland
| | | | - Paulina Salminen
- Division of Digestive Surgery and Urology, Department of Digestive SurgeryTurku University HospitalTurkuFinland
| | - Patricia Iozzo
- Institute of Clinical Physiology, National Research CouncilPisaItaly
| | - Pirjo Nuutila
- Turku PET CentreUniversity of TurkuTurkuFinland
- Department of EndocrinologyTurku University HospitalTurkuFinland
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Dutour A, Abdesselam I, Ancel P, Kober F, Mrad G, Darmon P, Ronsin O, Pradel V, Lesavre N, Martin JC, Jacquier A, Lefur Y, Bernard M, Gaborit B. Exenatide decreases liver fat content and epicardial adipose tissue in patients with obesity and type 2 diabetes: a prospective randomized clinical trial using magnetic resonance imaging and spectroscopy. Diabetes Obes Metab 2016; 18:882-91. [PMID: 27106272 DOI: 10.1111/dom.12680] [Citation(s) in RCA: 153] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/11/2016] [Accepted: 04/20/2016] [Indexed: 12/24/2022]
Abstract
AIM To conduct a prospective randomized trial to investigate the effect of glucagon-like peptide-1 (GLP-1) analogues on ectopic fat stores. METHODS A total of 44 obese subjects with type 2 diabetes uncontrolled on oral antidiabetic drugs were randomly assigned to receive exenatide or reference treatment according to French guidelines. Epicardial adipose tissue (EAT), myocardial triglyceride content (MTGC), hepatic triglyceride content (HTGC) and pancreatic triglyceride content (PTGC) were assessed 45 min after a standardized meal with 3T magnetic resonance imaging and proton magnetic resonance spectroscopy before and after 26 weeks of treatment. RESULTS The study population had a mean glycated haemoglobin (HbA1c) level of 7.5 ± 0.2% and a mean body mass index of 36.1 ± 1.1 kg/m(2) . Ninety five percent had hepatic steatosis at baseline (HTGC ≥ 5.6%). Exenatide and reference treatment led to a similar improvement in HbA1c (-0.7 ± 0.3% vs. -0.7 ± 0.4%; p = 0.29), whereas significant weight loss was observed only in the exenatide group (-5.5 ± 1.2 kg vs. -0.2 ± 0.8 kg; p = 0.001 for the difference between groups). Exenatide induced a significant reduction in EAT (-8.8 ± 2.1%) and HTGC (-23.8 ± 9.5%), compared with the reference treatment (EAT: -1.2 ± 1.6%, p = 0.003; HTGC: +12.5 ± 9.6%, p = 0.007). No significant difference was observed in other ectopic fat stores, PTGC or MTGC. In the group treated with exenatide, reductions in liver fat and EAT were not associated with homeostatic model assessment of insulin resistance index, adiponectin, HbA1c or fructosamin change, but were significantly related to weight loss (r = 0.47, p = 0.03, and r = 0.50, p = 0.018, respectively). CONCLUSION Our data indicate that exenatide is an effective treatment to reduce liver fat content and epicardial fat in obese patients with type 2 diabetes, and these effects are mainly weight loss dependent.
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Affiliation(s)
- A Dutour
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pole Endo, Marseille, France
| | - I Abdesselam
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
| | - P Ancel
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
| | - F Kober
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
| | - G Mrad
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
| | - P Darmon
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pole Endo, Marseille, France
| | - O Ronsin
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pole Endo, Marseille, France
| | - V Pradel
- Aix Marseille Université, Marseille, France
- Statistics Department, Assistance Publique Hôpitaux Marseille, CHU Sainte Marguerite, Marseille, France
| | - N Lesavre
- Aix Marseille Université, Marseille, France
- Centre d'investigation Clinique, 1409, Assistance Publique Hôpitaux de Marseille, CHU Nord, Marseille, France
| | - J C Martin
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
| | - A Jacquier
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
- Radiology Department, CHU La Timone, Marseille, France
| | - Y Lefur
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
| | - M Bernard
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
| | - B Gaborit
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pole Endo, Marseille, France
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de Heer P, Bizino MB, Lamb HJ, Webb AG. Parameter optimization for reproducible cardiac 1 H-MR spectroscopy at 3 Tesla. J Magn Reson Imaging 2016; 44:1151-1158. [PMID: 27016265 DOI: 10.1002/jmri.25254] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/08/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To optimize data acquisition parameters in cardiac proton MR spectroscopy, and to evaluate the intra- and intersession variability in myocardial triglyceride content. MATERIALS AND METHODS Data acquisition parameters at 3 Tesla (T) were optimized and reproducibility measured using, in total, 49 healthy subjects. The signal-to-noise-ratio (SNR) and the variance in metabolite amplitude between averages were measured for: (i) global versus local power optimization; (ii) static magnetic field (B0 ) shimming performed during free-breathing or within breathholds; (iii) post R-wave peak measurement times between 50 and 900 ms; (iv) without respiratory compensation, with breathholds and with navigator triggering; and (v) frequency selective excitation, Chemical Shift Selective (CHESS) and Multiply Optimized Insensitive Suppression Train (MOIST) water suppression techniques. Using the optimized parameters intra- and intersession myocardial triglyceride content reproducibility was measured. Two cardiac proton spectra were acquired with the same parameters and compared (intrasession reproducibility) after which the subject was removed from the scanner and placed back in the scanner and a third spectrum was acquired which was compared with the first measurement (intersession reproducibility). RESULTS Local power optimization increased SNR on average by 22% compared with global power optimization (P = 0.0002). The average linewidth was not significantly different for pencil beam B0 shimming using free-breathing or breathholds (19.1 Hz versus 17.5 Hz; P = 0.15). The highest signal stability occurred at a cardiac trigger delay around 240 ms. The mean amplitude variation was significantly lower for breathholds versus free-breathing (P = 0.03) and for navigator triggering versus free-breathing (P = 0.03) as well as for navigator triggering versus breathhold (P = 0.02). The mean residual water signal using CHESS (1.1%, P = 0.01) or MOIST (0.7%, P = 0.01) water suppression was significantly lower than using frequency selective excitation water suppression (7.0%). Using the optimized parameters an intrasession limits of agreement of the myocardial triglyceride content of -0.11% to +0.04%, and an intersession of -0.15% to +0.9%, were achieved. The coefficient of variation was 5% for the intrasession reproducibility and 6.5% for the intersession reproducibility. CONCLUSION Using approaches designed to optimize SNR and minimize the variation in inter-average signal intensities and frequencies/phases, a protocol was developed to perform cardiac MR spectroscopy on a clinical 3T system with high reproducibility. J. Magn. Reson. Imaging 2016;44:1151-1158.
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Affiliation(s)
- Paul de Heer
- C.J. Gorter Center for High Field MR, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maurice B Bizino
- Department of Radiology, Leiden University, Medical Center, Leiden, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University, Medical Center, Leiden, the Netherlands
| | - Andrew G Webb
- C.J. Gorter Center for High Field MR, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
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Liao PA, Lin G, Tsai SY, Wang CH, Juan YH, Lin YC, Wu MT, Yang LY, Liu MH, Chang TC, Lin YC, Huang YC, Huang PC, Wang JJ, Ng SH, Ng KK. Myocardial triglyceride content at 3 T cardiovascular magnetic resonance and left ventricular systolic function: a cross-sectional study in patients hospitalized with acute heart failure. J Cardiovasc Magn Reson 2016; 18:9. [PMID: 26850626 PMCID: PMC4744377 DOI: 10.1186/s12968-016-0228-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 01/25/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Increased myocardial triglyceride (TG) content has been recognized as a risk factor for cardiovascular disease. However, its relation with cardiac function in patients on recovery from acute heart failure (HF) remains unclear. In this cross-sectional study, we sought to investigate the association between myocardial TG content measured on magnetic resonance spectroscopy ((1)H-MRS) and left ventricular (LV) function assessed on cardiovascular magnetic resonance (CMR) in patients who were hospitalized with HF. METHODS A total of 50 patients who were discharged after hospitalization for acute HF and 21 age- and sex-matched controls were included in the study. Myocardial TG content and LV parameters (function and mass) were measured on a 3.0 T MR scanner. Fatty acid (FA) and unsaturated fatty acid (UFA) content was normalized against water (W) using the LC-Model algorithm. The patient population was dichotomized according to the left ventricular ejection fraction (LVEF, <50% or ≥ 50%). RESULTS H-MRS data were available for 48 patients and 21 controls. Of the 48 patients, 25 had a LVEF <50% (mean, 31.2%), whereas the remaining 23 had a normal LVEF (mean, 60.2%). Myocardial UFA/W ratio was found to differ significantly in patients with low LVEF, normal LVEF, and controls (0.79% vs. 0.21% vs. 0.14%, respectively, p = 0.02). The myocardial UFA/TG ratio was associated with LV mass (r = 0.39, p < 0.001) and modestly related to LV end-diastolic volume (LVEDV; r = 0.24, p = 0.039). We also identified negative correlations of the myocardial FA/TG ratio with both LV mass (r = -0.39, p < 0.001) and LVEDV (r = -0.24, p = 0.039). CONCLUSIONS As compared with controls, patients who were discharged after hospitalization for acute HF had increased myocardial UFA content; furthermore, UFA was inversely related with LVEF, LV mass and, to a lesser extent, LVEDV. Our study may stimulate further research on the measure of myocardial UFA content by (1)H-MRS for outcome prediction. TRIAL REGISTRATION ClinicalTrial.gov: NCT02378402 . Registered 27/02/2015.
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Affiliation(s)
- Pen-An Liao
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan.
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan.
- Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan.
| | - Shang-Yueh Tsai
- Graduate Institute of Applied Physics, National Chengchi University, Taipei, Taiwan.
| | - Chao-Hung Wang
- Department of Cardiology and Heart Failure Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
| | - Yu-Hsiang Juan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan.
| | - Yu-Ching Lin
- Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan.
| | - Ming-Ting Wu
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
| | - Lan-Yan Yang
- Clinical Trial Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
| | - Min-Hui Liu
- Department of Cardiology and Heart Failure Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
| | - Tsun-Ching Chang
- Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan.
| | - Yu-Chun Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan.
| | - Yu-Chieh Huang
- Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan.
| | - Pei-Ching Huang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan.
| | - Jiun-Jie Wang
- Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan.
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, 5 Fuhsing Street, Gueishan, Taoyuan, 333, Taiwan.
| | - Koon-Kwan Ng
- Department of Radiology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan.
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Nyman K, Granér M, Pentikäinen MO, Lundbom J, Hakkarainen A, Sirén R, Nieminen MS, Taskinen MR, Lundbom N, Lauerma K. Cardiac steatosis and left ventricular function in men with metabolic syndrome. J Cardiovasc Magn Reson 2013; 15:103. [PMID: 24228979 PMCID: PMC3842676 DOI: 10.1186/1532-429x-15-103] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 11/05/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ectopic accumulation of fat accompanies visceral obesity with detrimental effects. Lipid oversupply to cardiomyocytes leads to cardiac steatosis, and in animal studies lipotoxicity has been associated with impaired left ventricular (LV) function. In humans, studies have yielded inconclusive results. The aim of the study was to evaluate the role of epicardial, pericardial and myocardial fat depots on LV structure and function in male subjects with metabolic syndrome (MetS). METHODS A study population of 37 men with MetS and 38 men without MetS underwent cardiovascular magnetic resonance and proton magnetic spectroscopy at 1.5 T to assess LV function, epicardial and pericardial fat area and myocardial triglyceride (TG) content. RESULTS All three fat deposits were greater in the MetS than in the control group (p <0.001). LV diastolic dysfunction was associated with MetS as measured by absolute (471 mL/s vs. 667 mL/s, p = 0.002) and normalized (3.37 s⁻¹ vs. 3.75 s⁻¹, p = 0.02) LV early diastolic peak filling rate and the ratio of early diastole (68% vs. 78%, p = 0.001). The amount of epicardial and pericardial fat correlated inversely with LV diastolic function. However, myocardial TG content was not independently associated with LV diastolic dysfunction. CONCLUSIONS In MetS, accumulation of epicardial and pericardial fat is linked to the severity of structural and functional alterations of the heart. The role of increased intramyocardial TG in MetS is more complex and merits further study.
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Affiliation(s)
- Kristofer Nyman
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Haartmaninkatu 4, BOX 340, FI-00029 HUS, Finland
| | - Marit Granér
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Markku O Pentikäinen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Jesper Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Haartmaninkatu 4, BOX 340, FI-00029 HUS, Finland
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Haartmaninkatu 4, BOX 340, FI-00029 HUS, Finland
| | - Reijo Sirén
- Department of General Practice and Primary Health Care, Health Care Centre of City of Helsinki and University of Helsinki, Helsinki, Finland
| | - Markku S Nieminen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Marja-Riitta Taskinen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Haartmaninkatu 4, BOX 340, FI-00029 HUS, Finland
| | - Kirsi Lauerma
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Stenbäckinkatu 11, BOX 281, Helsinki FI-00029 HUS, Finland
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