Diabetes induces remodeling of the left atrial appendage independently of atrial fibrillation in a rodent model of type-2 diabetes.


Journal

Cardiovascular diabetology
ISSN: 1475-2840
Titre abrégé: Cardiovasc Diabetol
Pays: England
ID NLM: 101147637

Informations de publication

Date de publication:
23 07 2021
Historique:
received: 02 07 2021
accepted: 15 07 2021
entrez: 24 7 2021
pubmed: 25 7 2021
medline: 4 1 2022
Statut: epublish

Résumé

Diabetic patients have an increased predisposition to thromboembolic events, in most cases originating from thrombi in the left atrial appendage (LAA). Remodeling of the LAA, which predisposes to thrombi formation, has been previously described in diabetic patients with atrial fibrillation, but whether remodeling of the LAA occurs in diabetics also in the absence of atrial fibrillation is unknown. To investigate the contribution of diabetes, as opposed to atrial fibrillation, to remodeling of the LAA, we went from humans to the animal model. We studied by echocardiography the structure and function of the heart over multiple time points during the evolution of diabetes in the Cohen diabetic sensitive rat (CDs/y) provided diabetogenic diet over a period of 4 months; CDs/y provided regular diet and the Cohen diabetic resistant (CDr/y), which do not develop diabetes, served as controls. All animals were in sinus rhythm throughout the study period. Compared to controls, CDs/y developed during the evolution of diabetes a greater heart mass, larger left atrial diameter, wider LAA orifice, increased LAA depth, greater end-diastolic and end-systolic diameter, and lower E/A ratio-all indicative of remodeling of the LAA and left atrium (LA), as well as the development of left ventricular diastolic dysfunction. To investigate the pathophysiology involved, we studied the histology of the hearts at the end of the study. We found in diabetic CDs/y, but not in any of the other groups, abundance of glycogen granules in the atrial appendages , atria  and ventricles, which may be of significance as glycogen granules have previously been associated with cell and organ dysfunction in the diabetic heart. We conclude that our rodent model of diabetes, which was in sinus rhythm, reproduced structural and functional alterations previously observed in hearts of human diabetics with atrial fibrillation. Remodeling of the LAA and of the LA in our model was unrelated to atrial fibrillation and associated with accumulation of glycogen granules. We suggest that myocardial accumulation of glycogen granules is related to the development of diabetes and may play a pathophysiological role in remodeling of the LAA and LA, which predisposes to atrial fibrillation, thromboembolic events and left ventricular diastolic dysfunction in the diabetic heart.

Sections du résumé

BACKGROUND
Diabetic patients have an increased predisposition to thromboembolic events, in most cases originating from thrombi in the left atrial appendage (LAA). Remodeling of the LAA, which predisposes to thrombi formation, has been previously described in diabetic patients with atrial fibrillation, but whether remodeling of the LAA occurs in diabetics also in the absence of atrial fibrillation is unknown. To investigate the contribution of diabetes, as opposed to atrial fibrillation, to remodeling of the LAA, we went from humans to the animal model.
METHODS
We studied by echocardiography the structure and function of the heart over multiple time points during the evolution of diabetes in the Cohen diabetic sensitive rat (CDs/y) provided diabetogenic diet over a period of 4 months; CDs/y provided regular diet and the Cohen diabetic resistant (CDr/y), which do not develop diabetes, served as controls. All animals were in sinus rhythm throughout the study period.
RESULTS
Compared to controls, CDs/y developed during the evolution of diabetes a greater heart mass, larger left atrial diameter, wider LAA orifice, increased LAA depth, greater end-diastolic and end-systolic diameter, and lower E/A ratio-all indicative of remodeling of the LAA and left atrium (LA), as well as the development of left ventricular diastolic dysfunction. To investigate the pathophysiology involved, we studied the histology of the hearts at the end of the study. We found in diabetic CDs/y, but not in any of the other groups, abundance of glycogen granules in the atrial appendages , atria  and ventricles, which may be of significance as glycogen granules have previously been associated with cell and organ dysfunction in the diabetic heart.
CONCLUSIONS
We conclude that our rodent model of diabetes, which was in sinus rhythm, reproduced structural and functional alterations previously observed in hearts of human diabetics with atrial fibrillation. Remodeling of the LAA and of the LA in our model was unrelated to atrial fibrillation and associated with accumulation of glycogen granules. We suggest that myocardial accumulation of glycogen granules is related to the development of diabetes and may play a pathophysiological role in remodeling of the LAA and LA, which predisposes to atrial fibrillation, thromboembolic events and left ventricular diastolic dysfunction in the diabetic heart.

Identifiants

pubmed: 34301258
doi: 10.1186/s12933-021-01347-x
pii: 10.1186/s12933-021-01347-x
pmc: PMC8306366
doi:

Substances chimiques

Glycogen 9005-79-2

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

149

Informations de copyright

© 2021. The Author(s).

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Auteurs

Or Yosefy (O)

Department of Cardiology, Barzilai University Medical Center, 2 Hahistadrut Street, 78278, Ashkelon, Israel.

Barucha Sharon (B)

Department of Cardiology, Barzilai University Medical Center, 2 Hahistadrut Street, 78278, Ashkelon, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.

Chana Yagil (C)

Laboratory for Molecular Medicine and Israeli Rat Genome Center, Barzilai University Medical Center, 2 Hahistadrut Street, 78278, Ashkelon, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.

Mark Shlapoberski (M)

Department of Pathology, Barzilai University Medical Center, Ashkelon, Israel.

Alejandro Livoff (A)

Department of Pathology, Barzilai University Medical Center, Ashkelon, Israel.

Ilana Novitski (I)

Department of Pathology, Barzilai University Medical Center, Ashkelon, Israel.

Ronen Beeri (R)

Diagnostic Cardiology Unit, Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel.

Yoram Yagil (Y)

Laboratory for Molecular Medicine and Israeli Rat Genome Center, Barzilai University Medical Center, 2 Hahistadrut Street, 78278, Ashkelon, Israel. labmomed@bgu.ac.il.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel. labmomed@bgu.ac.il.

Chaim Yosefy (C)

Department of Cardiology, Barzilai University Medical Center, 2 Hahistadrut Street, 78278, Ashkelon, Israel. chaimy@bmc.gov.il.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel. chaimy@bmc.gov.il.

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