Related Experiment Video
Updated: Jun 10, 2025
Multimodal Study of Murine Cardiovascular Remodeling: Four-Dimensional Ultrasound and Mass Spectrometry Imaging
Published on: January 10, 2025
Associations between glycated haemoglobin and multi-modal imaging markers of early cardiac aging
Abigail C C Chng1, Hong Chang Tan2,3, Louis L Y Teo1,2
1National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
Insights
Glycated haemoglobin (HbA1c) may predict myocardial aging in older adults without diabetes. Higher HbA1c levels are linked to altered heart function, suggesting its use in assessing cardiovascular risk.
Area of Science:
- Cardiology
- Endocrinology
- Gerontology
Background:
- Glycated haemoglobin (HbA1c) is a key biomarker for diabetes management and cardiovascular death risk.
- Its role in predicting myocardial aging in non-diabetic adults without cardiovascular disease (CVD) remains unexplored.
Purpose of the Study:
- To investigate the association between HbA1c and myocardial aging markers in older adults without CVD or diabetes.
- To determine if HbA1c can predict distinct signatures of myocardial aging.
Main Methods:
- Comprehensive cardiovascular and metabolic assessments in older adults without CVD.
- Echocardiography and cardiac magnetic resonance (CMR) for left ventricular and left atrial (LA) strain analysis.
- Blood sampling for HbA1c and other biomarkers.
Main Results:
- HbA1c was significantly associated with E/A ratio, LA conduit strain (Ɛe), conduit strain rate (SRe), and SRe:SRa ratio.
- These associations persisted independently after adjusting for clinical factors and excluding diabetic subjects.
- Increased HbA1c correlated with lower E/A ratio, lower Ɛe, higher SRe, and lower SRe:SRa ratio.
Conclusions:
- HbA1c shows distinct associations with myocardial functions relevant to the aging heart.
- HbA1c may serve as a valuable biomarker for risk stratification in myocardial aging, irrespective of diabetes status.
Background:
Glycated haemoglobin (HbA1c) is a well-established biomarker for diabetes diagnosis and management and is linked to risk of cardiovascular death. However, among adults without cardiovascular disease (CVD) and diabetes, the value of HbA1c in predicting distinct signatures of myocardial ageing has not been explored.
Methods:
Subjects, from among older adults without CVD, underwent comprehensive cardiovascular and metabolic assessment. Transthoracic echocardiography measured left ventricular structure and function. Longitudinal left atrial (LA) strain comprising reservoir strain (Ɛs), conduit strain (Ɛe) and booster strain (Ɛa) and their corresponding peak strain rates (SRs, SRe, SRa) were measured using cardiac magnetic resonance (CMR). Blood sampling for biomarkers and cardiovascular examinations were performed.
Results:
247 subjects (mean age 71 years, 44.1% female, mean HbA1c 6.0%) were included. HbA1c was significantly associated with E/A ratio (p < 0.0001), conduit strain (Ɛe) (p < 0.0001), conduit strain rate SRe (p < 0.0001), and conduit strain rate to booster strain rate SRe:SRa ratio (p < 0.0001). Multivariate models adjusting for clinical variables such as body mass index, blood pressure, heart rate, diabetes mellitus, smoking, and associated cardiac parameters, demonstrated a persistent independent association. Each unit increase in HbA1c was associated with lower E/A ratio, lower Ɛe, higher SRe and lower SRe:SRa ratio. These associations remained significant after diabetic subjects were excluded.
Conclusion:
Distinct associations were found between HbA1c and myocardial functions of interest in the ageing heart. HbA1c may be useful biomarker for stratifying risks associated with myocardial ageing, independent of diabetes status.
Trial Registration:
ClinicalTrials.gov Identifier: NCT02791139.
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