Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes
Abstract Background Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure with preserved ejection fraction and cardiac arrhythmias. Precursors of these complications, such as diabetic cardiomyopathy, remain incompletely understood and underdiagnosed. Detection of early signs of ca...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-10-01
|
| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-024-02465-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571996927426560 |
|---|---|
| author | Ambre Bertrand Andrew Lewis Julia Camps Vicente Grau Blanca Rodriguez |
| author_facet | Ambre Bertrand Andrew Lewis Julia Camps Vicente Grau Blanca Rodriguez |
| author_sort | Ambre Bertrand |
| collection | DOAJ |
| description | Abstract Background Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure with preserved ejection fraction and cardiac arrhythmias. Precursors of these complications, such as diabetic cardiomyopathy, remain incompletely understood and underdiagnosed. Detection of early signs of cardiac deterioration in T2DM patients is critical for prevention. Our goal is to quantify T2DM-driven abnormalities in ECG and cardiac imaging biomarkers leading to cardiovascular disease. Methods We quantified ECG and cardiac magnetic resonance imaging biomarkers in two matched cohorts of 1781 UK Biobank participants, with and without T2DM, and no diagnosed cardiovascular disease at the time of assessment. We performed a pair-matched cross-sectional study to compare cardiac biomarkers in both cohorts, and examined the association between T2DM and these biomarkers. We built multivariate multiple linear regression models sequentially adjusted for socio-demographic, lifestyle, and clinical covariates. Results Participants with T2DM had a higher resting heart rate (66 vs. 61 beats per minute, p < 0.001), longer QTc interval (424 vs. 420ms, p < 0.001), reduced T wave amplitude (0.33 vs. 0.37mV, p < 0.001), lower stroke volume (72 vs. 78ml, p < 0.001) and thicker left ventricular wall (6.1 vs. 5.9mm, p < 0.001) despite a decreased Sokolow-Lyon index (19.1 vs. 20.2mm, p < 0.001). T2DM was independently associated with higher heart rate (beta = 3.11, 95% CI = [2.11,4.10], p < 0.001), lower stroke volume (beta = −4.11, 95% CI = [−6.03, −2.19], p < 0.001) and higher left ventricular wall thickness (beta = 0.133, 95% CI = [0.081,0.186], p < 0.001). Trends were consistent in subgroups of different sex, age and body mass index. Fewer significant differences were observed in participants of non-white ethnic background. QRS duration and Sokolow-Lyon index showed a positive association with the development of cardiovascular disease in cohorts with and without T2DM, respectively. A higher left ventricular mass and wall thickness were associated with cardiovascular outcomes in both groups. Conclusion T2DM prior to cardiovascular disease was linked with a higher heart rate, QTc prolongation, T wave amplitude reduction, as well as lower stroke volume and increased left ventricular wall thickness. Increased QRS duration and left ventricular wall thickness and mass were most strongly associated with future cardiovascular disease. Although subclinical, these changes may indicate the presence of autonomic dysfunction and diabetic cardiomyopathy. Graphical Abstract |
| format | Article |
| id | doaj-art-4d8d35861b974528a11652e4bfd6a070 |
| institution | Kabale University |
| issn | 1475-2840 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj-art-4d8d35861b974528a11652e4bfd6a0702025-02-02T12:07:22ZengBMCCardiovascular Diabetology1475-28402024-10-0123111310.1186/s12933-024-02465-yMulti-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetesAmbre Bertrand0Andrew Lewis1Julia Camps2Vicente Grau3Blanca Rodriguez4Computational Cardiovascular Science Group, Department of Computer Science, University of OxfordDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, University of OxfordComputational Cardiovascular Science Group, Department of Computer Science, University of OxfordInstitute of Biomedical Engineering, Department of Engineering Science, University of OxfordComputational Cardiovascular Science Group, Department of Computer Science, University of OxfordAbstract Background Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure with preserved ejection fraction and cardiac arrhythmias. Precursors of these complications, such as diabetic cardiomyopathy, remain incompletely understood and underdiagnosed. Detection of early signs of cardiac deterioration in T2DM patients is critical for prevention. Our goal is to quantify T2DM-driven abnormalities in ECG and cardiac imaging biomarkers leading to cardiovascular disease. Methods We quantified ECG and cardiac magnetic resonance imaging biomarkers in two matched cohorts of 1781 UK Biobank participants, with and without T2DM, and no diagnosed cardiovascular disease at the time of assessment. We performed a pair-matched cross-sectional study to compare cardiac biomarkers in both cohorts, and examined the association between T2DM and these biomarkers. We built multivariate multiple linear regression models sequentially adjusted for socio-demographic, lifestyle, and clinical covariates. Results Participants with T2DM had a higher resting heart rate (66 vs. 61 beats per minute, p < 0.001), longer QTc interval (424 vs. 420ms, p < 0.001), reduced T wave amplitude (0.33 vs. 0.37mV, p < 0.001), lower stroke volume (72 vs. 78ml, p < 0.001) and thicker left ventricular wall (6.1 vs. 5.9mm, p < 0.001) despite a decreased Sokolow-Lyon index (19.1 vs. 20.2mm, p < 0.001). T2DM was independently associated with higher heart rate (beta = 3.11, 95% CI = [2.11,4.10], p < 0.001), lower stroke volume (beta = −4.11, 95% CI = [−6.03, −2.19], p < 0.001) and higher left ventricular wall thickness (beta = 0.133, 95% CI = [0.081,0.186], p < 0.001). Trends were consistent in subgroups of different sex, age and body mass index. Fewer significant differences were observed in participants of non-white ethnic background. QRS duration and Sokolow-Lyon index showed a positive association with the development of cardiovascular disease in cohorts with and without T2DM, respectively. A higher left ventricular mass and wall thickness were associated with cardiovascular outcomes in both groups. Conclusion T2DM prior to cardiovascular disease was linked with a higher heart rate, QTc prolongation, T wave amplitude reduction, as well as lower stroke volume and increased left ventricular wall thickness. Increased QRS duration and left ventricular wall thickness and mass were most strongly associated with future cardiovascular disease. Although subclinical, these changes may indicate the presence of autonomic dysfunction and diabetic cardiomyopathy. Graphical Abstracthttps://doi.org/10.1186/s12933-024-02465-yDiabetes mellitus (type 2)Cardiovascular diseasesElectrocardiographyMagnetic resonance imagingCross-sectional studiesUK Biobank |
| spellingShingle | Ambre Bertrand Andrew Lewis Julia Camps Vicente Grau Blanca Rodriguez Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes Cardiovascular Diabetology Diabetes mellitus (type 2) Cardiovascular diseases Electrocardiography Magnetic resonance imaging Cross-sectional studies UK Biobank |
| title | Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes |
| title_full | Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes |
| title_fullStr | Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes |
| title_full_unstemmed | Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes |
| title_short | Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes |
| title_sort | multi modal characterisation of early stage subclinical cardiac deterioration in patients with type 2 diabetes |
| topic | Diabetes mellitus (type 2) Cardiovascular diseases Electrocardiography Magnetic resonance imaging Cross-sectional studies UK Biobank |
| url | https://doi.org/10.1186/s12933-024-02465-y |
| work_keys_str_mv | AT ambrebertrand multimodalcharacterisationofearlystagesubclinicalcardiacdeteriorationinpatientswithtype2diabetes AT andrewlewis multimodalcharacterisationofearlystagesubclinicalcardiacdeteriorationinpatientswithtype2diabetes AT juliacamps multimodalcharacterisationofearlystagesubclinicalcardiacdeteriorationinpatientswithtype2diabetes AT vicentegrau multimodalcharacterisationofearlystagesubclinicalcardiacdeteriorationinpatientswithtype2diabetes AT blancarodriguez multimodalcharacterisationofearlystagesubclinicalcardiacdeteriorationinpatientswithtype2diabetes |