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  11. The Impact Of Type 2 Diabetes Mellitus On The Clinical Profile, Myocardial Fibrosis, And Prognosis In Non-ischemic Dilated Cardiomyopathy: A Prospective Cohort Study

The impact of type 2 diabetes mellitus on the clinical profile, myocardial fibrosis, and prognosis in non-ischemic dilated cardiomyopathy: a prospective cohort study

Yangjie Li1, Hong Xian2, Yuanwei Xu1

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, P. R. China.

Cardiovascular Diabetology
|February 2, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Type 2 diabetes mellitus (T2DM) in patients with non-ischemic dilated cardiomyopathy (DCM) is linked to a more severe clinical profile and worse outcomes. This includes increased mortality and heart failure deaths, highlighting T2DM as a significant risk factor in DCM patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Imaging

Background:

  • The clinical impact of coexisting type 2 diabetes mellitus (T2DM) in non-ischemic dilated cardiomyopathy (DCM) patients on their clinical status, myocardial fibrosis, and overall outcomes requires further elucidation.
  • Understanding these associations is crucial for risk stratification and management strategies in this patient population.

Purpose of the Study:

  • To investigate the impact of T2DM on clinical characteristics, myocardial fibrosis, and clinical outcomes in patients with non-ischemic DCM.
  • To compare the profiles and prognoses of DCM patients with and without T2DM.

Main Methods:

  • A prospective cohort study of 1152 non-ischemic DCM patients (June 2012-October 2021), divided into T2DM and non-T2DM groups.
  • Clinical data, cardiac function, and myocardial fibrosis (via CMR with LGE, native T1, and ECV) were assessed.
Keywords:
Dilated cardiomyopathyMyocardial fibrosisPrognosisType 2 diabetes mellitus

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  • Primary endpoint: all-cause mortality and heart transplantation. Cox regression and Kaplan-Meier analyses were used, with propensity score matching (PSM) applied.

    • Main Results:

    • 155 (13%) patients had T2DM. T2DM patients were older, had higher NYHA class, more comorbidities (hypertension, atrial fibrillation), lower LVEF, and increased LGE, native T1, and ECV.
    • Over a median 38-month follow-up, T2DM patients showed significantly worse outcomes (10.2% vs. 5.7% annual event rate, P<0.001).
    • T2DM independently predicted adverse outcomes (HR 1.61 overall, HR 1.54 in PSM cohort) and was associated with higher rates of heart failure and non-cardiac death.

    Conclusions:

    • Patients with T2DM exhibit a more severe clinical profile and face significantly worse clinical outcomes compared to non-T2DM patients within a large non-ischemic DCM cohort.
    • T2DM is an independent predictor of adverse events, including mortality, in this population.
    • These findings underscore the importance of managing T2DM in DCM patients to improve prognosis.