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Dépistage des altérations précoces de la fonction régionale myocardique par échocardiographie de stress et effet d’une intervention par supplémentation en vitamine D3 dans le diabète de type 2 : approche translationnelle

Abstract : Diabetes has reached the 7th place in the world’s top ten mortality causes. In this population, morbi-mortality mainly originates from diabetic cardiomyopathy. This complication evolving from the onset of diabetes, early diagnosis and care are of paramount importance and are the two purposes of this work. In our first study, we demonstrated the relevance of a comprehensive 2D speckle-tracking imaging analysis, under dobutamine stress, in unmasking early left ventricular regional myocardial dysfunction in a population of asymptomatic type 2 diabetic patients. In the second part of this work, we performed two studies. In the first one, we brought to light an improvement of regional myocardial function response to dobutamine stress after a three-month vitamin D3 supplementation protocol, in deficient patients. The second study was performed in a mouse model of diet-induced type 2 diabetes. In this last work, we put forward the beneficial effects of vitamin D3 supplementation, in secondary prevention, on cardiac remodeling and function. These cardioprotective effects may be, at least in part, on account of modulatory effects of vitamin D3 on myocardial lipotoxic species levels. This whole work allow us to propose a tool enabling recognition of early cardiac function impairments in type 2 diabetic patients and to demonstrate the beneficial effects of vitamin D3 supplementation in this context.
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https://tel.archives-ouvertes.fr/tel-02073591
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Clothilde Philouze. Dépistage des altérations précoces de la fonction régionale myocardique par échocardiographie de stress et effet d’une intervention par supplémentation en vitamine D3 dans le diabète de type 2 : approche translationnelle. Cardiologie et système cardiovasculaire. Université d'Avignon, 2018. Français. ⟨NNT : 2018AVIG0346⟩. ⟨tel-02073591⟩

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