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19 Prospective longitudinal characterization of the relationship between diabetes and cardiac structural and functional changes
  1. Amrit Chowdhary1,
  2. Nicholas Jex1,
  3. Sharmaine Thirunavukarasu1,
  4. Amanda MacCannell1,
  5. Natalie haywood1,
  6. Altaf Almutairi1,
  7. Lavanya Atithan2,
  8. Manali Jain1,
  9. Thomas Craven1,
  10. Arka Das1,
  11. Noor Sharrack1,
  12. Christopher Saunderson1,
  13. Anshuman Sengupta3,
  14. Lee Roberts1,
  15. Peter Swoboda1,
  16. Richard Cubbon4,
  17. Klaus Witte1,
  18. John Greenwood1,
  19. Sven Plein1,
  20. Eylem Levelt5
  1. 1University of Leeds, Leeds, UK
  2. 2University of Leicester
  3. 3Leeds Teaching Hospitals NHS Trust
  4. 4Discovery and Translational Science Department Leeds Institute of Cardiovascular and Metabolic Medic
  5. 5University of Leeds, Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science


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.

Abstract 19 Figure 1

Central illustration

Abstract 19 Figure 2

Major adverse cardiovascular event ratesThe major adverse cardiovascular event rate (MI, angina, revascularisation, CVA, death) during the 6-year follow-up period, including the patients with a silent MI, amounted to 25% in this study with an overall clinical event rate of 35%

Abstract 19 Table 1

CMR findings

Abstract 19 Table 2

Clinical andbiochemical characteristics at baseline of the participants with and withoutMACE (angina, myocardial infarction, revascularization and cerebrovascularaccident) at follow-up

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

  • Type 2 Diabetes Mellitus
  • Cardiovascular Magnetic Resonance Imaging
  • Cardiac Remodelling

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