19 Prospective longitudinal characterization of the relationship between diabetes and cardiac structural and functional changes. (4th June 2021)

• Record Type: Journal Article
• Authors: Chowdhary, Amrit; Jex, Nicholas; Thirunavukarasu, Sharmaine; MacCannell, Amanda; haywood, Natalie; Almutairi, Altaf; Atithan, Lavanya; Jain, Manali; Craven, Thomas; Das, Arka; Sharrack, Noor; Saunderson, Christopher; Sengupta, Anshuman; Roberts, Lee; Swoboda, Peter; Cubbon, Richard; Witte, Klaus; Greenwood, John; Plein, Sven; Levelt, Eylem
• Is Part Of: Heart. Volume 107(2021)Supplement 1
• Page Start: A15
• Page End: A17
• Publication Date: 2021-06-04
• Subjects: Type 2 Diabetes Mellitus -- Cardiovascular Magnetic Resonance Imaging -- Cardiac Remodelling; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2021-BCS.19
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: In a cohort of type 2 diabetes (T2D) patients who underwent baseline cardiac magnetic resonance (CMR) and biomarker testing, during a median follow-up of 6-years we aimed to determine longitudinal changes in the phenotypic expression of heart disease in diabetes; report clinical outcomes; and compare baseline clinical characteristics and CMR findings of patients who experienced major adverse cardiovascular events (MACE) to those remaining MACE free ( figure 1 ) . Background: T2D increases the risk of heart failure (HF) and cardiovascular mortality. The long-term impact of T2D on cardiac phenotype in the absence of cardiovascular disease and other clinical events is unknown. Methods: T2D patients (n=100) with no history of cardiovascular disease or hypertension were recruited at baseline. Biventricular volumes, function, and myocardial extracellular volume fraction (ECV) were assessed by CMR and blood biomarkers taken. Follow-up CMR was repeated in those without interim clinical events after 6-years. Results: Follow-up was successful in 83 participants. Of those, 29 experienced cardiovascular/clinical events (36%) ( figure 2 ). Of the remaining 59, 32 patients who experienced no events received follow-up CMR. In this cohort, despite no significant changes in blood pressure, weight, or glycated-hemoglobin, significant reductions in biventricular end-diastolic-volumes and ejection fractions occurred over time ( tables 1 & 2 ) . The mean ECV was unchanged. Baseline plasma high-sensitivity cardiac-troponin-T (hs-cTnT) was significantly associated with change in left ventricular (LV) ejection fraction. Patients who experienced MACE had higher LV mass and greater LV concentricity than those who remained event-free. Conclusions: T2D results in reductions in biventricular size and systolic function over time even in the absence of cardiovascular/clinical events. Conflict of Interest: Nil