Neutrophil degranulation biomarkers characterize restrictive echocardiographic pattern with diastolic dysfunction in patients with diabetes

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Objective: investigating the potential association between neutrophils degranulation and patterns of myocardial dysfunction in a cohort of patients with type 2 diabetes mellitus (T2DM). Background: Two distinct phenotypes of diabetic cardiomyopathy have been described: a restrictive phenotype with diastolic dysfunction (restrictive/DD) and a dilative phenotype with systolic dysfunction (dilative/SD). However, the underlying determinants of these two patterns are not yet recognized METHODS: In this single-center, observational, cross-sectional study 492 patients were recruited. Ultrasonographic measurements were performed by two experienced sonographers, blinded to the clinical data of the participants. Serum biomarkers of neutrophils degranulation were measured by enzyme-linked immunosorbent sandwich assay (ELISA). Results: After adjustment for confounders, resistin, myeloperoxidase, matrix metalloproteinase 8 and matrix metalloproteinase 9/tissue inhibitor of metalloproteinases 1 complex were positively associated with the restrictive/DD pattern compared to the normal pattern. Similarly, MPO was positively associated with the dilative/SD pattern compared to the normal pattern, and resistin was negatively associated with the dilative/SD pattern compared to the restrictive/DD pattern. Conclusions: neutrophil degranulation is associated with the restrictive/DD echocardiographic pattern in patients with T2DM, but not normal pattern and dilative/SD patterns. Neutrophils could have a pivotal role in the pathogenesis of myocardial dysfunction, and particularly diastolic dysfunction, in patients with T2DM.

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