SA JOURNAL OF DIABETES & VASCULAR DISEASE RESEARCH ARTICLE VOLUME 20 NUMBER 1 • JUNE 2023 13 The pathophysiological mechanisms by which IR promotes LVH and diastolic dysfunction have been the subject of several experimental studies.22-24 The starting point of a complex metabolic cascade during IR, culminating in structural and functional anomalies of the left ventricle, is the almost exclusive recourse to the metabolism of fatty acids as fuel. Indeed, in a situation of adequate insulin sensitivity, free fatty acids constitute the main fuel for the production of energy22,25 necessary for uninterrupted and highly endergonic myocardial activity.22 However, the heart machinery is capable of remarkable metabolic adaptability, allowing it, if necessary, to resort to other sources of energy such as glucose, pyruvate and ketone bodies.22,26 Fig. 1. HOMAIR and left ventricular end-diastole diameter. Fig. 4. HOMAIR and sum of wall thickness. Fig. 2. HOMAIR and interventricular septum. Fig. 5. HOMAIR and left ventricular mass indexed to height2.7. Fig. 3. HOMAIR and posterior wall thickness. Fig. 6. HOMAIR and left ventricular mass indexed to body surface area.
RkJQdWJsaXNoZXIy NDIzNzc=