Evaluation of the effects of glycated hemoglobin on cardiac function in patients with short-duration type 2 diabetes mellitus: A cardiovascular magnetic resonance study

Zhou, Fangli; Deng, Miao; Deng, Liling; Li, Yuan-mei; Mo, Dan; Xie, Linjun; Gao, Yue; Tian, Haoming; Guo, Yingkun; Ren, Yan

doi:10.1016/j.diabres.2021.108952

Cited by 10 publications

(15 citation statements)

References 37 publications

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“…Each 1% increase in HbA1c is linked to an 8% increase in the risk of HF in T2DM [ 29 ]. In addition to HF, poor glycemic control is an independent determinant of LV myocardial strains for T2DM patients [ 30 ]. More importantly, the relationship between HbA1c and HF has been reported in NIDCM patients as well.…”

Section: Discussionmentioning

confidence: 99%

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

Shen

Guo

et al. 2022

Cardiovasc Diabetol

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Background Type 2 diabetes mellitus (T2DM) increases the risk of worse long-term outcomes in patients with non-ischemic dilated cardiomyopathy (NIDCM). However, the additive effects of T2DM on left ventricular (LV) function in NIDCM remain unclear. Accordingly, we aimed to investigate the impact of comorbid T2DM on LV deformation in NIDCM individuals. Materials and methods Three hundred forty-two NIDCM patients without T2DM [NIDCM (T2DM−)], 93 with T2DM [NIDCM (T2DM+)] and 80 age- and sex-matched normal controls who underwent cardiac magnetic resonance scanning were included. LV geometry, function, and LV global strains, including peak strain (PS), peak systolic strain rate (PSSR) and peak diastolic strain rate (PDSR) in the radial, circumferential and longitudinal directions, were measured. NIDCM (T2DM+) patients were divided into two subgroups based on the HbA1c level (< 7.0% and ≥ 7.0%). The determinants of reduced LV myocardial strain for all NIDCM individuals and NIDCM (T2DM+) patients were assessed using multivariable linear regression analyses. Results Compared with normal controls, both NIDCM (T2DM −) and NIDCM (T2DM+) patients exhibited increased LV end-diastolic and end-systolic volume index and decreased LV ejection fraction. LV global strains progressively declined from the normal controls to the NIDCM (T2DM−) group to the NIDCM (T2DM+) group (all p < 0.017), except for radial PDSR and PSSR. Subgroup analysis showed that LV global radial PS and longitudinal PS, PSSR-L and PDSR-L were worse in NIDCM patients with poor glycemic control than in those with good glycemic control (p < 0.017). T2DM was an independent determinant of reduced LV global circumferential PS and longitudinal PS in patients with NIDCM (both p < 0.05). An increased HbA1c level was independently associated with a decreased global radial PS (β = − 0.285, p < 0.01) and longitudinal PS (β = 0.320, p < 0.01) in NIDCM (T2DM+) patients. Conclusions T2DM has an additive deleterious effect on LV systolic and diastolic function in NIDCM patients. Among NIDCM patients with T2DM, HbA1c was found to be associated with reduced LV myocardial strain.

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Section: Discussionmentioning

confidence: 99%

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

Shen

Guo

et al. 2022

Cardiovasc Diabetol

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“…Increased HbA1c levels were generally associated with elevated CVD risk [6,7,19], while lower levels of HbA1c may not consistently relate with a beneficial CVD outcome [20,21]. In our study, we demonstrated an approximately J-shaped association between HbA1c levels and risk of CVD amongst patients with gout with the inflection point of approaching 5.0%.…”

Section: Discussionmentioning

confidence: 59%

“…6 Centre for Evaluation of Medicines, St Joseph's Health Care, Hamilton, ON, Canada. 7 Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.…”

Section: Abbreviationsmentioning

confidence: 99%

“…Glycated hemoglobin (HbA1c) as a hemoglobin-glucose combination formed nonenzymatically within the cell, indicates average blood glucose concentrations over the prior 3 months [5]. Emerging studies showed that higher HbA1c levels were associated with elevated cardiovascular risk [6,7]; however, some randomized control trials have highlighted that a low HbA1c level may not consistently yield a beneficial outcome from cardiovascular disease (CVD) events [8,9]. Published guidelines have provided a detailed recommendation of optimal HbA1c…”

Section: Introductionmentioning

confidence: 99%

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Associations between glycated hemoglobin and the risks of incident cardiovascular diseases in patients with gout

Lip

et al. 2022

Cardiovasc Diabetol

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Background Evidence for the relationship between glycated hemoglobin (HbA1c) levels and risk of cardiovascular diseases (CVD) in patients with gout remained sparse and limited. This study aims to explore the associations between HbA1c levels and risks of incident CVD in patients with gout. Methods We included patients with gout who had an HbA1c measurement at baseline from the UK Biobank. CVD events were identified from through medical and death records. We used multivariable Cox proportional hazards model with a restricted cubic spline to assess the potential non-linear effect of HbA1c on CVD risk. Results We included a total of 6,685 patients (mean age 59.7; 8.1% females) with gout for analyses. During a mean follow-up of 7.3 years, there were 1,095 CVD events documented with an incidence of 2.26 events per 100 person-years (95% confidence interval [CI]: 2.13–2.40). A quasi J-shaped association between HbA1c and risk of CVD was observed, with the potentially lowest risk found at the HbA1c of approximately 5.0% (hazard ratio [HR] = 0.65, 95% CI: 0.53–0.81). When compared with the HbAlc level of 7%, a significantly decreased risk of CVD was found from 5.0 to 6.5%, while an increased risk was observed at 7.5% (HR = 1.05) and 8.0% (HR = 1.09). Subgroup analyses yielded similar results to the main findings in general. Conclusions Based on data from a nationwide, prospective, population-based cohort, we found a quasi J-shaped relationship between HbA1c and risk of CVD in patients with gout. More high-quality evidence is needed to further clarify the relationship between HbA1c and CVD risk in patients with gout.

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“…About a 1% increase in HbA1c is associated with an 8% increased risk of heart failure [ 56 , 57 ]. In a recent Chinese study on 64 adult subjects with type DMT2 and 30 healthy controls, LV myocardial function, evaluated by cMRI, was impaired in patients with uncontrolled DMT2 (HbA1c ≥ 7%) and diabetes duration < 10 years as compared with healthy control [ 58 ]. Moreover, poor glucose control was an independent predictor of LV myocardial dysfunction in this population.…”

Section: Role Of Glucose Control In Diabetic Cardiomyopathymentioning

confidence: 99%

Glycemic Control and the Heart: The Tale of Diabetic Cardiomyopathy Continues

et al. 2022

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Cardiovascular diseases are the leading cause of death in people with diabetes. Diabetic cardiomyopathy (DC) is an important complication of diabetes and represents a distinct subtype of heart failure that occurs in absence of cardiovascular diseases. Chronic hyperglycemia and hyperinsulinemia along with insulin resistance and inflammatory milieu are the main mechanisms involved in the pathophysiology of DC. Changes in lifestyle favoring healthy dietary patterns and physical activity, combined with more innovative anti-diabetes therapies, are the current treatment strategies to safeguard the cardiovascular system. This review aims at providing an updated comprehensive overview of clinical, pathogenetic, and molecular aspects of DC, with a focus on the effects of anti-hyperglycemic drugs on the prevention of pump dysfunction and consequently on cardiovascular health in type 2 diabetes.

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Evaluation of the effects of glycated hemoglobin on cardiac function in patients with short-duration type 2 diabetes mellitus: A cardiovascular magnetic resonance study

Cited by 10 publications

References 37 publications

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

Associations between glycated hemoglobin and the risks of incident cardiovascular diseases in patients with gout

Glycemic Control and the Heart: The Tale of Diabetic Cardiomyopathy Continues

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