Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography: The Thousand & 1 study

Magnus Thorsten Jensen; Peter Søgaard; Henrik Ullits Andersen; Ida Gustafsson; Jan Bech; Thomas Fritz Hansen; Simone Theilade; Thomas Almdal; Peter Rossing; Jan Skov Jensen

doi:10.1177/1479164116637310

Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography: The Thousand & 1 study

Magnus Thorsten Jensen, Peter Søgaard, Henrik Ullits Andersen, Ida Gustafsson, Jan Bech, Thomas Fritz Hansen, Simone Theilade, Thomas Almdal, Peter Rossing, Jan Skov Jensen

Institut for Klinisk Medicin

13 Citationer (Scopus)

Abstract

Purpose: Cardiovascular disease is the most common cause of mortality in type 1 diabetes; patients with albuminuria are at greatest risk. We investigated myocardial function and premature myocardial impairment in type 1 diabetes patients with and without albuminuria compared to controls. Methods: This study included a cross-sectional survey of 1093 type 1 diabetes patients from Steno Diabetes Center and 200 healthy controls. Conventional and tissue Doppler echocardiographic measurements were analysed in multivariable models in normoalbuminuria (n = 760), microalbuminuria (n = 227) and macroalbuminuria (n = 106). Investigators were blinded to degree of albuminuria. Results: For the type 1 diabetes patients, mean age was 49.6 years, 53% were men and mean diabetes duration was 25.5 years. In multivariable models systolic velocity s′ did not differ between type 1 diabetes patients with normoalbuminuria and controls (β-coefficient [95% confidence interval]: â'0.17 [â'0.41; 0.08], p = 0.19), but was impaired between controls and microalbuminuria (â'0.53 [â'0.84; â'0.23], p = 0.001) and macroalbuminuria (â'0.59 [â'0.96; â'0.22], p = 0.002). Diastolic measurements (e′, a′, e′/a′, and E/e′) were all significantly impaired in type 1 diabetes, for example, e′/a′: normoalbuminuria, microalbuminuria and macroalbuminuria versus controls: â'0.38 [â'0.52; â'0.23], p < 0.001; â'0.49 [â'0.67; â'0.32], p < 0.001; and â'0.81 [â'1.03; â'0.59], p < 0.001. In age-related analyses, myocardial impairment occurred prematurely in type 1 diabetes compared to controls (e.g. E/e′ = 8; 9.2 years [normoalbuminuria], 17.3 years [microalbuminuria] and 41.4 years [macroalbuminuria] prematurely, respectively). Conclusion: In type 1 diabetes patients with albuminuria, both systolic and diastolic functions are impaired, whereas in patients without albuminuria only diastolic function is affected. Myocardial impairment is detectable many years prematurely in type 1 diabetes, especially in patients with albuminuria.

Originalsprog	Engelsk
Tidsskrift	Diabetes and Vascular Disease Research
Vol/bind	13
Udgave nummer	4
Sider (fra-til)	260-7
Antal sider	8
ISSN	1479-1641
DOI	https://doi.org/10.1177/1479164116637310
Status	Udgivet - jul. 2016

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Jensen, M. T., Søgaard, P., Andersen, H. U., Gustafsson, I., Bech, J., Hansen, T. F., Theilade, S., Almdal, T., Rossing, P., & Jensen, J. S. (2016). Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography: The Thousand & 1 study. Diabetes and Vascular Disease Research, 13(4), 260-7. https://doi.org/10.1177/1479164116637310

Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography : The Thousand & 1 study. / Jensen, Magnus Thorsten; Søgaard, Peter; Andersen, Henrik Ullits et al.

I: Diabetes and Vascular Disease Research, Bind 13, Nr. 4, 07.2016, s. 260-7.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Jensen, MT, Søgaard, P, Andersen, HU, Gustafsson, I, Bech, J, Hansen, TF, Theilade, S, Almdal, T , Rossing, P & Jensen, JS 2016, 'Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography: The Thousand & 1 study', Diabetes and Vascular Disease Research, bind 13, nr. 4, s. 260-7. https://doi.org/10.1177/1479164116637310

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title = "Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography: The Thousand & 1 study",

abstract = "Purpose: Cardiovascular disease is the most common cause of mortality in type 1 diabetes; patients with albuminuria are at greatest risk. We investigated myocardial function and premature myocardial impairment in type 1 diabetes patients with and without albuminuria compared to controls. Methods: This study included a cross-sectional survey of 1093 type 1 diabetes patients from Steno Diabetes Center and 200 healthy controls. Conventional and tissue Doppler echocardiographic measurements were analysed in multivariable models in normoalbuminuria (n = 760), microalbuminuria (n = 227) and macroalbuminuria (n = 106). Investigators were blinded to degree of albuminuria. Results: For the type 1 diabetes patients, mean age was 49.6 years, 53% were men and mean diabetes duration was 25.5 years. In multivariable models systolic velocity s′ did not differ between type 1 diabetes patients with normoalbuminuria and controls (β-coefficient [95% confidence interval]: {\^a}'0.17 [{\^a}'0.41; 0.08], p = 0.19), but was impaired between controls and microalbuminuria ({\^a}'0.53 [{\^a}'0.84; {\^a}'0.23], p = 0.001) and macroalbuminuria ({\^a}'0.59 [{\^a}'0.96; {\^a}'0.22], p = 0.002). Diastolic measurements (e′, a′, e′/a′, and E/e′) were all significantly impaired in type 1 diabetes, for example, e′/a′: normoalbuminuria, microalbuminuria and macroalbuminuria versus controls: {\^a}'0.38 [{\^a}'0.52; {\^a}'0.23], p < 0.001; {\^a}'0.49 [{\^a}'0.67; {\^a}'0.32], p < 0.001; and {\^a}'0.81 [{\^a}'1.03; {\^a}'0.59], p < 0.001. In age-related analyses, myocardial impairment occurred prematurely in type 1 diabetes compared to controls (e.g. E/e′ = 8; 9.2 years [normoalbuminuria], 17.3 years [microalbuminuria] and 41.4 years [macroalbuminuria] prematurely, respectively). Conclusion: In type 1 diabetes patients with albuminuria, both systolic and diastolic functions are impaired, whereas in patients without albuminuria only diastolic function is affected. Myocardial impairment is detectable many years prematurely in type 1 diabetes, especially in patients with albuminuria.",

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author = "Jensen, {Magnus Thorsten} and Peter S{\o}gaard and Andersen, {Henrik Ullits} and Ida Gustafsson and Jan Bech and Hansen, {Thomas Fritz} and Simone Theilade and Thomas Almdal and Peter Rossing and Jensen, {Jan Skov}",

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T1 - Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography

T2 - The Thousand & 1 study

AU - Jensen, Magnus Thorsten

AU - Søgaard, Peter

AU - Andersen, Henrik Ullits

AU - Gustafsson, Ida

AU - Bech, Jan

AU - Hansen, Thomas Fritz

AU - Theilade, Simone

AU - Almdal, Thomas

AU - Rossing, Peter

AU - Jensen, Jan Skov

PY - 2016/7

Y1 - 2016/7

N2 - Purpose: Cardiovascular disease is the most common cause of mortality in type 1 diabetes; patients with albuminuria are at greatest risk. We investigated myocardial function and premature myocardial impairment in type 1 diabetes patients with and without albuminuria compared to controls. Methods: This study included a cross-sectional survey of 1093 type 1 diabetes patients from Steno Diabetes Center and 200 healthy controls. Conventional and tissue Doppler echocardiographic measurements were analysed in multivariable models in normoalbuminuria (n = 760), microalbuminuria (n = 227) and macroalbuminuria (n = 106). Investigators were blinded to degree of albuminuria. Results: For the type 1 diabetes patients, mean age was 49.6 years, 53% were men and mean diabetes duration was 25.5 years. In multivariable models systolic velocity s′ did not differ between type 1 diabetes patients with normoalbuminuria and controls (β-coefficient [95% confidence interval]: â'0.17 [â'0.41; 0.08], p = 0.19), but was impaired between controls and microalbuminuria (â'0.53 [â'0.84; â'0.23], p = 0.001) and macroalbuminuria (â'0.59 [â'0.96; â'0.22], p = 0.002). Diastolic measurements (e′, a′, e′/a′, and E/e′) were all significantly impaired in type 1 diabetes, for example, e′/a′: normoalbuminuria, microalbuminuria and macroalbuminuria versus controls: â'0.38 [â'0.52; â'0.23], p < 0.001; â'0.49 [â'0.67; â'0.32], p < 0.001; and â'0.81 [â'1.03; â'0.59], p < 0.001. In age-related analyses, myocardial impairment occurred prematurely in type 1 diabetes compared to controls (e.g. E/e′ = 8; 9.2 years [normoalbuminuria], 17.3 years [microalbuminuria] and 41.4 years [macroalbuminuria] prematurely, respectively). Conclusion: In type 1 diabetes patients with albuminuria, both systolic and diastolic functions are impaired, whereas in patients without albuminuria only diastolic function is affected. Myocardial impairment is detectable many years prematurely in type 1 diabetes, especially in patients with albuminuria.

AB - Purpose: Cardiovascular disease is the most common cause of mortality in type 1 diabetes; patients with albuminuria are at greatest risk. We investigated myocardial function and premature myocardial impairment in type 1 diabetes patients with and without albuminuria compared to controls. Methods: This study included a cross-sectional survey of 1093 type 1 diabetes patients from Steno Diabetes Center and 200 healthy controls. Conventional and tissue Doppler echocardiographic measurements were analysed in multivariable models in normoalbuminuria (n = 760), microalbuminuria (n = 227) and macroalbuminuria (n = 106). Investigators were blinded to degree of albuminuria. Results: For the type 1 diabetes patients, mean age was 49.6 years, 53% were men and mean diabetes duration was 25.5 years. In multivariable models systolic velocity s′ did not differ between type 1 diabetes patients with normoalbuminuria and controls (β-coefficient [95% confidence interval]: â'0.17 [â'0.41; 0.08], p = 0.19), but was impaired between controls and microalbuminuria (â'0.53 [â'0.84; â'0.23], p = 0.001) and macroalbuminuria (â'0.59 [â'0.96; â'0.22], p = 0.002). Diastolic measurements (e′, a′, e′/a′, and E/e′) were all significantly impaired in type 1 diabetes, for example, e′/a′: normoalbuminuria, microalbuminuria and macroalbuminuria versus controls: â'0.38 [â'0.52; â'0.23], p < 0.001; â'0.49 [â'0.67; â'0.32], p < 0.001; and â'0.81 [â'1.03; â'0.59], p < 0.001. In age-related analyses, myocardial impairment occurred prematurely in type 1 diabetes compared to controls (e.g. E/e′ = 8; 9.2 years [normoalbuminuria], 17.3 years [microalbuminuria] and 41.4 years [macroalbuminuria] prematurely, respectively). Conclusion: In type 1 diabetes patients with albuminuria, both systolic and diastolic functions are impaired, whereas in patients without albuminuria only diastolic function is affected. Myocardial impairment is detectable many years prematurely in type 1 diabetes, especially in patients with albuminuria.

KW - Journal Article

U2 - 10.1177/1479164116637310

DO - 10.1177/1479164116637310

M3 - Journal article

C2 - 27190082

SN - 1479-1641

VL - 13

SP - 260

EP - 267

JO - Diabetes and Vascular Disease Research

JF - Diabetes and Vascular Disease Research

IS - 4

ER -

Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography: The Thousand & 1 study

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