Anderson, ToddFriedrich, MatthiasSchmidt, Anna2016-01-262016-01-262016-01-262016http://hdl.handle.net/11023/2776The unrelenting incidence of obesity and type 2 diabetes has become a global public health concern. Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in these cohorts. Cardiovascular Magnetic Resonance (CMR) imaging is a robust imaging modality with techniques to provide sensitive detection of early cardiovascular changes in obesity and diabetes. In a prospective study of obese adolescents (n=11, 10 to 20 years old) and a healthy weight control group (n=14), we found obesity was associated with increases in Left ventricular (LV) mass, LV wall thickness and mass:volume ratio. In this “early stage” of remodeling, these structural changes were not associated with elevations in Native T1, a surrogate marker of tissue fibrosis. Strain analysis, by novel CMR tissue tracking analysis, revealed a hyper-contractile state, likely representing a combined contribution of elevated systolic blood pressure with compensatory myocyte hypertrophy. Obese subjects were additionally enrolled in a comprehensive 6-month lifestyle intervention; subjects did not experience weight loss or any change in cardiac parameters after 6 months. Further along the natural history of CVD as related to metabolic disease, the second study looked to examine possible sub-clinical changes in the hearts of otherwise healthy diabetic patients. This study examined twenty-eight healthy type 2 diabetic patients without any observable vascular complications. The complementary use of CMR-based T1 mapping and 3-dimensional strain analysis demonstrated expansion of the extracellular matrix and a reduction in global longitudinal strain. In the endpoint of the cardiometabolic disease spectrum, we analyzed individuals with known or suspected Coronary Artery Disease. This study explored the relationship between intra-thoracic fat volume (ITFV) and 4D myocardial strain-based markers of adverse remodeling. In non-infarcted myocardium, ITFV is associated with reductions in myocardial strain. These findings suggest ITFV to be a potentially important marker of adverse ventricular remodeling. The findings of these three studies suggest a capacity of contemporary CMR to identify early changes in cardiometabolic disease and also lend insight into the progression of diabetic heart disease. CMR provides a non-invasive, accurate and reproducible imaging modality with the potential to be useful in screening and CVD risk-stratification.engUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.Biophysics--MedicalImagingDiabetesCardiovascular DiseaseObesitydoctoral thesis10.11575/PRISM/25216