Glycemic Status, Cardiac Structure, and Function by Magnetic Resonance Imaging: The Jackson Heart Study

Type 2 diabetes is associated with a high risk of heart failure. Hence, precise cardiac imaging can help early detection of subclinical myocardial dysfunction. We investigated the associations of glycemic status and markers with left ventricular (LV) remodeling assessed by cardiac magnetic resonance imaging among Black adults.

Peak systolic circumferential strain (Eulerian circumferential systolic strain), LV mass, end-diastolic volume, end-systolic volume, LV ejection fraction, and LV remodeling index were measured by cardiac magnetic resonance imaging in JHS (Jackson Heart Study) participants between 2008 and 2012. We evaluated the associations of glycemic markers (fasting plasma glucose and hemoglobin A_1C) and glycemic status (diabetes, prediabetes, and normoglycemia) with cardiac magnetic resonance imaging measures of LV structure and function.

A total of 1609 Black participants (mean age, 59 years; 63% women; 27.4% with diabetes and 46.8% with prediabetes) were included. Participants with diabetes had higher LV mass (adjusted β, 4.94 [95% CI, 0.51-9.37]), higher LV remodeling index (β, 0.05 [95% CI: 0.01- 0.09]), impaired global circumferential systolic strain (β, 0.44 [95% CI, 0.04-0.84]), and a higher odds of abnormal strain compared with those with normoglycemia (adjusted odds ratio, 1.43 [95% CI, 1.01-2.04]). Each SD increase in hemoglobin A_1C was associated with higher LV mass (β, 2.48 [95% CI, 0.76-4.21]), LV remodeling index (β, 0.02 [95% CI, 0.01-0.04]), and impaired global circumferential systolic strain (β, 0.21 [95% CI, 0.06-0.37]).

In a large community-based cohort of Black individuals, diabetes was associated with differences in LV structure and myocardial strain measured by cardiac magnetic resonance imaging.