The correlation between epicardial fat thickness and longitudinal left atrial reservoir strain in patients with type 2 diabetes mellitus and controls

Abstract Background Diabetes mellitus (DM) has been documented among the strongest risk factors for developing heart failure with preserved ejection fraction (HFpEF). The earliest imaging changes in patients with DM are the left atrial (LA) functional and volumetric changes. The aim of this study was to determine the correlation between epicardial fat thickness (EFT) and longitudinal LA reservoir strain (LARS) in patients with type 2 DM (T2DM), as compared with non-diabetic controls. Results The study samples in this case-control study comprised of consecutive patients with T2DM (n=64) and matched non-diabetic controls (n=30). An echocardiography was performed on all patients and EFT, volumetric and longitudinal LARS, left ventricular (LV) global longitudinal strain (LVGLS), pulsed-wave Doppler-derived transmitral early (E wave) and late (A wave) diastolic velocities, and tissue-Doppler-derived mitral annular early diastolic (e′) and peak systolic (s') velocities were obtained. The study results demonstrated that the patients with T2DM had thicker EFT (5.96±2.13 vs. 4.10±3.11 mm) and increased LA volume index (LAVI) (43.05± 44.40 vs. 29.10±11.34 ml/m2) in comparison with the non-diabetic ones (p-value: 0.005 and 0.022, respectively). On the other hand, a direct association was observed between EFT and the E/e′ ratio, and an inverse correlation was established between EFT and LARS in patients with T2DM (r=0.299, p-value=0.020 and r=− 0.256, p-value=0.043, respectively). However, regression analysis showed only LV mass index (LVMI) (β=0.012, 95% CI 0.006–0.019, p-value<0.001), LAVI (β=− 0.034, 95% CI − 0.05–0.017, p-value<0.001), and EFT (β=− 0.143, 95% CI − 0.264–− 0.021, p-value=0.021) were independently correlated with LARS. Conclusions LARS is considered as an important early marker of subclinical cardiac dysfunction. Thickened epicardial fat may be an independent risk factor for decreased LA reservoir strain. Diabetics are especially considered as a high risk group due to having an increased epicardial adipose tissue thickness

The Effect of Prenatal Stress on Seizure Threshold and Histomorphometrical Changes on Cerebellar Cortex in NMRI Mice

Abstract Background: Stress is a mental or emotional disturbance that occurs in response to external stimuli and can also appear during pregnancy. The aim of this study is to investigate the effect of maternal stress during pregnancy on the cerebellar structure changes and seizure threshold of their offspring. Materials and Methods: In this experimental study, 20 pregnant female rats were divided into two groups: 1) Non stress group, and 2) Stress group which were under immobilization stress one hour for 14 days. The seizure threshold test in offspring was performed by injecting Pantilen tetrazol drug (PTZ)(n=8). To investigate the cerebellum development, the offspring were divided into three groups. Control group: mothers did not any stress and offspring did not receive PTZ(n=4). Sham group: mothers did not stress but the offspring had received PTZ(n=4). Experimental group: mothers did stress and offispring did receive PTZ(n=4). After the section of cerebellum, the thickness of cerebellum layers and the number of cells in each layer were evaluated. Results: The mean of seizure threshold in the offspring whose mothers were under the stress of pregnancy significantly increased compared to children whose mothers no received stress (p<0.001). In the other side, mean number of purkinje cells in the experimental group significantly decreased compared with the other groups (p<0.001). No significant differences were found in the mean of granular and molecular layers thickness of cerebellum in the experimental group when compared with the other groups(p<0.05). However, mean cellular density in the granular layer of cerebellum in the experimental group significantly decreased compared to other groups (p<0.001). Conclusion: Stress during pregnancy increased the seizure threshold in offspring and caused some developmental and structural disorders in the cerebellar rat offspring