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Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
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Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model

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Impact of Diabetes on Myocardial Fibrosis in Patients With Hypertension: The REMODEL Study

Chee Jian Pua1, Germaine Loo2, Michelle Kui2

  • 1National Heart Research Institute of Singapore, Singapore (C.J.P, A.-A.H., V.L., D.-F.T., S.A.C., T.-T.L., C.W.L.C.), National Heart Centre Singapore, Singapore.

Circulation. Cardiovascular Imaging
|July 11, 2023
PubMed

Insights

Patients with hypertension and diabetes show worse cardiac remodeling than those with hypertension alone. Novel protein signatures linked to inflammation may explain these differences in myocardial fibrosis.

Area of Science:

  • Cardiovascular Medicine
  • Proteomics
  • Medical Imaging

Background:

  • Hypertension and diabetes mellitus (HTN/DM) confer a worse prognosis than hypertension alone.
  • Understanding morphological and molecular differences is crucial for patient outcomes.

Purpose of the Study:

  • To characterize morphological differences between hypertension and HTN/DM using cardiovascular magnetic resonance (CMR).
  • To compare differentially expressed proteins associated with myocardial fibrosis in these patient groups.

Main Methods:

  • Asymptomatic patients (hypertension: n=438; HTN/DM: n=167) underwent CMR.
  • Replacement fibrosis identified by late gadolinium enhancement; diffuse fibrosis by extracellular volume fraction.
  • 184 serum proteins measured using high-throughput multiplex assays to identify fibrosis signatures.

Main Results:

  • HTN/DM patients exhibited increased concentricity and worse multidirectional strain despite similar LV mass and blood pressure.
  • Replacement myocardial fibrosis was more prevalent in HTN/DM (28%) vs. hypertension (16%).
  • NT-proBNP associated with fibrosis in hypertension; GDF-15 associated with fibrosis in HTN/DM. Inflammatory pathways linked to fibrosis in HTN/DM.

Conclusions:

  • Patients with HTN/DM demonstrate adverse cardiac remodeling compared to hypertension alone.
  • Novel proteomic signatures, including increased immune and inflammatory responses, may underlie myocardial fibrosis in HTN/DM.
Abstract

Keywords:
heart diseasehypertensionmagnetic resonance imagingmyocardial fibrosis

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