Left Ventricular Structure, Tissue Composition, and Aortic Distensibility in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Intervention and Complications

Authors

Evrim B. Turkbey, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health Bethesda, Maryland.
Jye-Yu C. Backlund, The Biostatistics Center, The George Washington University, Rockville, Maryland.
Neville Gai, National Heart, Lung and Blood Institute, Bethesda, Maryland.
Marcelo Nacif, Department of Radiology, Federal Fluminense University, Rio de Janeiro, Brazil.
Rob J. van der Geest, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
John M. Lachin, The Biostatistics Center, The George Washington University, Rockville, Maryland.
Anderson Armstrong, School of Medicine, Universidade Federal do Vale do São Francisco, Petrolina, Brazil.
Gustavo J. Volpe, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil.
Saman Nazarian, Cardiac Electrophysiology, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
João A. Lima, Department of Cardiology, Johns Hopkins University, Baltimore, Maryland.
David A. Bluemke, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address: dbluemke@wisc.edu.

Document Type

Journal Article

Publication Date

7-1-2022

Journal

The American journal of cardiology

Volume

174

DOI

10.1016/j.amjcard.2022.03.036

Abstract

Alterations in myocardial structure, function, tissue composition (e.g., fibrosis) may be associated with metabolic syndrome (MetS). This study aimed to determine the relation of MetS and its individual components to markers of cardiovascular disease in patients with type 1 Diabetes Mellitus (T1DM). A total of 978 subjects of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications T1DM cohort (age: 49 ± 7 years, 47% female, DM duration 28 ± 5 years) underwent cardiovascular magnetic resonance. In a subset of 200 patients, myocardial tissue composition was measured with cardiovascular magnetic resonance T1 mapping after contrast administration. MetS was defined as T1DM plus 2 other abnormalities based on the American Heart Association/National Cholesterol Education Program criteria. MetS was present in 34.1% of subjects. After adjustment for age, height, scanner, study cohort, gender, smoking, mean glycated hemoglobin levels, history of macroalbuminuria and end-stage renal disease, left ventricle mass was greater by 12.3 g, end-diastolic volume was higher by 5.4 ml, and mass to end-diastolic volume ratio was higher by 5% in patients with MetS versus those without MetS (p <0.001 for all). Myocardial T1 times were lower by 29 ms in patients with MetS than those without (p <0.001). Elevated waist circumference showed the strongest associations with left ventricle mass (+10.1 g), end-diastolic volume (+6.7 ml), and lower myocardial T1 times (+31 ms) in patients with MetS compared with those without (p <0.01). In conclusion, in a large cohort of patients with T1DM, 34.1% of subjects met MetS criteria. MetS was associated with adverse myocardial structural remodeling and change in myocardial tissue composition.

APA Citation

Turkbey, Evrim B.; Backlund, Jye-Yu C.; Gai, Neville; Nacif, Marcelo; van der Geest, Rob J.; Lachin, John M.; Armstrong, Anderson; Volpe, Gustavo J.; Nazarian, Saman; Lima, João A.; and Bluemke, David A., "Left Ventricular Structure, Tissue Composition, and Aortic Distensibility in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Intervention and Complications" (2022). GW Authored Works. Paper 1369.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1369

Department

Biostatistics and Bioinformatics