Prospective Longitudinal Characterization of the Relationship between Diabetes and Cardiac Structural and Functional...

Area of Science:

• Cardiology
• Diabetology
• Medical Imaging

Background:

• Type 2 diabetes (T2D) significantly elevates risks for heart failure and cardiovascular mortality.
• The long-term effects of T2D on cardiac phenotype, particularly in individuals without pre-existing cardiovascular disease, remain largely uncharacterized.

Purpose of the Study:

• To investigate longitudinal changes in cardiac phenotype among type 2 diabetic patients.
• To document clinical outcomes and compare cardiovascular event occurrences.
• To analyze baseline clinical and cardiac magnetic resonance imaging (CMR) findings in relation to major adverse cardiovascular events (MACE).

Main Methods:

• A cohort of 100 type 2 diabetic patients without prior cardiovascular disease or hypertension was recruited.
• Baseline assessments included CMR for biventricular volumes, function, and extracellular volume fraction (ECV), alongside blood biomarker analysis.
• Follow-up CMR was conducted after 6 years in patients who remained event-free.

Main Results:

• A 6-year follow-up was completed by 83 participants; 36% experienced cardiovascular events.
• Despite stable blood pressure, weight, and HbA1c, significant decreases in biventricular volumes and ejection fractions were observed.
• Higher baseline left ventricular (LV) mass and concentricity were noted in patients who experienced MACE.

Conclusions:

• Type 2 diabetes is associated with progressive reductions in biventricular size and systolic function over time.
• These cardiac changes occur even in the absence of overt cardiovascular or clinical events.
• Baseline hs-cTnT levels correlated with changes in LV ejection fraction, suggesting early myocardial damage markers.