The adverse effects of metabolic disorder on left ventricular myocardial mechano-energetic efficiency and dysfunction in ischemic cardiomyopathy: insight from a cardiac MRI study

Abstract Purpose Metabolic risk factors (MetF) have emerged as the leading drivers of ischemic cardiomyopathy (ICM) worldwide. However, in patients who have already experienced myocardial ischemia/infarction, whether and in what pattern the MetF act on the heart needs to be further elucidated. This...

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Main Authors: Li Jiang, Yuan Li, Xue-Ming Li, Ke Shi, Han Fang, Wei‑Feng Yan, Ying‑Kun Guo, Hua‑Yan Xu, Zhi-Gang Yang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Cardiovascular Diabetology
Online Access:https://doi.org/10.1186/s12933-025-02817-2
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author Li Jiang
Yuan Li
Xue-Ming Li
Ke Shi
Han Fang
Wei‑Feng Yan
Ying‑Kun Guo
Hua‑Yan Xu
Zhi-Gang Yang
author_facet Li Jiang
Yuan Li
Xue-Ming Li
Ke Shi
Han Fang
Wei‑Feng Yan
Ying‑Kun Guo
Hua‑Yan Xu
Zhi-Gang Yang
author_sort Li Jiang
collection DOAJ
description Abstract Purpose Metabolic risk factors (MetF) have emerged as the leading drivers of ischemic cardiomyopathy (ICM) worldwide. However, in patients who have already experienced myocardial ischemia/infarction, whether and in what pattern the MetF act on the heart needs to be further elucidated. This study aims to determine the adverse effects of MetF on left ventricular (LV) indexed myocardial mechano-energetic efficiency (MEEi) and dysfunction in patients with ICM, and further clarify which MetF classification is more clinically significant. Materials and methods This study retrospectively included 201 patients with ICM who underwent cardiac magnetic resonance imaging (MRI) examinations, and further divided them into the following three groups according to the number of coexisting MetF: The groups with no MetF (MetF-0 group, n = 32), with 1–2 MetF (MetF-1, n = 92) and with 3–5 MetF (MetF-2, n = 77). The clinical variables and MRI-derived parameters were measured and compared among the three groups. Multivariate linear regression analysis was performed to determine independent correlation of MetF on LV MEEi and strain in ICM patients. Results LV global circumferential peak strain (PS) gradually decreased from MetF-0 group, through MetF-1 group, to MetF-2 group (− 9.52 ± 2.70% vs. − 7.62 ± 2.73% vs. − 6.50 ± 2.70%, P < 0.001). MetF-1 and MetF-2 groups both showed lower MEEi, lower LV global radial and longitudinal PS than MetF-0 group (Both P < 0.001), while there was no statistically significant difference between MetF-1 and MetF-2 groups (P > 0.05). Multivariate analyses indicated that the coexisting any MetF was independently associated with decreased LV MEEi (β = − 0.093, P = 0.018) and PS (Radial, β = − 0.232, P < 0.001; Circumferential, β = 0.156, P = 0.002; Longitudinal, β = 0.192, P = 0.008), and the increase in the number of coexisting MetF was only related to the reduction of circumferential PS (β = 0.238, P = 0.006). Conclusions Our results revealed whether coexisting any MetF, rather than coexisting a greater number of MetF, is associated with the reduction of LV myocardial mechano-energetic efficiency and dysfunction in patients with ICM, suggesting that clinicians should promptly identify and treat any coexisting MetF in the management of ICM patients. Graphical abstract
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spelling doaj-art-eddffc932ef8413fbb01f5ba613336172025-08-20T03:45:22ZengBMCCardiovascular Diabetology1475-28402025-07-0124111310.1186/s12933-025-02817-2The adverse effects of metabolic disorder on left ventricular myocardial mechano-energetic efficiency and dysfunction in ischemic cardiomyopathy: insight from a cardiac MRI studyLi Jiang0Yuan Li1Xue-Ming Li2Ke Shi3Han Fang4Wei‑Feng Yan5Ying‑Kun Guo6Hua‑Yan Xu7Zhi-Gang Yang8Department of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan UniversityDepartment of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityAbstract Purpose Metabolic risk factors (MetF) have emerged as the leading drivers of ischemic cardiomyopathy (ICM) worldwide. However, in patients who have already experienced myocardial ischemia/infarction, whether and in what pattern the MetF act on the heart needs to be further elucidated. This study aims to determine the adverse effects of MetF on left ventricular (LV) indexed myocardial mechano-energetic efficiency (MEEi) and dysfunction in patients with ICM, and further clarify which MetF classification is more clinically significant. Materials and methods This study retrospectively included 201 patients with ICM who underwent cardiac magnetic resonance imaging (MRI) examinations, and further divided them into the following three groups according to the number of coexisting MetF: The groups with no MetF (MetF-0 group, n = 32), with 1–2 MetF (MetF-1, n = 92) and with 3–5 MetF (MetF-2, n = 77). The clinical variables and MRI-derived parameters were measured and compared among the three groups. Multivariate linear regression analysis was performed to determine independent correlation of MetF on LV MEEi and strain in ICM patients. Results LV global circumferential peak strain (PS) gradually decreased from MetF-0 group, through MetF-1 group, to MetF-2 group (− 9.52 ± 2.70% vs. − 7.62 ± 2.73% vs. − 6.50 ± 2.70%, P < 0.001). MetF-1 and MetF-2 groups both showed lower MEEi, lower LV global radial and longitudinal PS than MetF-0 group (Both P < 0.001), while there was no statistically significant difference between MetF-1 and MetF-2 groups (P > 0.05). Multivariate analyses indicated that the coexisting any MetF was independently associated with decreased LV MEEi (β = − 0.093, P = 0.018) and PS (Radial, β = − 0.232, P < 0.001; Circumferential, β = 0.156, P = 0.002; Longitudinal, β = 0.192, P = 0.008), and the increase in the number of coexisting MetF was only related to the reduction of circumferential PS (β = 0.238, P = 0.006). Conclusions Our results revealed whether coexisting any MetF, rather than coexisting a greater number of MetF, is associated with the reduction of LV myocardial mechano-energetic efficiency and dysfunction in patients with ICM, suggesting that clinicians should promptly identify and treat any coexisting MetF in the management of ICM patients. Graphical abstracthttps://doi.org/10.1186/s12933-025-02817-2
spellingShingle Li Jiang
Yuan Li
Xue-Ming Li
Ke Shi
Han Fang
Wei‑Feng Yan
Ying‑Kun Guo
Hua‑Yan Xu
Zhi-Gang Yang
The adverse effects of metabolic disorder on left ventricular myocardial mechano-energetic efficiency and dysfunction in ischemic cardiomyopathy: insight from a cardiac MRI study
Cardiovascular Diabetology
title The adverse effects of metabolic disorder on left ventricular myocardial mechano-energetic efficiency and dysfunction in ischemic cardiomyopathy: insight from a cardiac MRI study
title_full The adverse effects of metabolic disorder on left ventricular myocardial mechano-energetic efficiency and dysfunction in ischemic cardiomyopathy: insight from a cardiac MRI study
title_fullStr The adverse effects of metabolic disorder on left ventricular myocardial mechano-energetic efficiency and dysfunction in ischemic cardiomyopathy: insight from a cardiac MRI study
title_full_unstemmed The adverse effects of metabolic disorder on left ventricular myocardial mechano-energetic efficiency and dysfunction in ischemic cardiomyopathy: insight from a cardiac MRI study
title_short The adverse effects of metabolic disorder on left ventricular myocardial mechano-energetic efficiency and dysfunction in ischemic cardiomyopathy: insight from a cardiac MRI study
title_sort adverse effects of metabolic disorder on left ventricular myocardial mechano energetic efficiency and dysfunction in ischemic cardiomyopathy insight from a cardiac mri study
url https://doi.org/10.1186/s12933-025-02817-2
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