Impact of type 2 diabetes and duration of type 2 diabetes on cardiac structure and function

Peter G Jørgensen; Magnus T Jensen; Rasmus Mogelvang; Thomas Fritz Hansen; Søren Galatius; Tor Biering-Sørensen; Heidi Storgaard; Tina Vilsbøll Lauritsen; Peter Rossing; Jan S Jensen

doi:10.1016/j.ijcard.2016.07.083

Impact of type 2 diabetes and duration of type 2 diabetes on cardiac structure and function

Peter G Jørgensen, Magnus T Jensen, Rasmus Mogelvang, Thomas Fritz Hansen, Søren Galatius, Tor Biering-Sørensen, Heidi Storgaard, Tina Vilsbøll Lauritsen, Peter Rossing, Jan S Jensen

Institut for Klinisk Medicin

27 Citationer (Scopus)

Abstract

Background Contemporary treatment of type 2 diabetes (T2D) has improved patient outcome and may also have affected myocardial structure and function. We aimed to describe the effect of T2D and T2D duration on cardiac structure and function in a large outpatient population. Methods We performed comprehensive echocardiography on a representative sample of 1004 persons including a representative sample of 770 patients with T2D without known heart disease and 234 age- and sex-matched controls. Results T2D was associated with increased left ventricular (LV) wall thicknesses and decreased LV internal diameter and the changes were pronounced with increasing diabetes duration (P < 0.01 for all) but not with increased LV mass (P = 0.74). It was also significantly associated with the prevalence of diastolic dysfunction (16.5% vs. 4.0%; P < 0.001), with indices of LV relaxation and elevated filling pressures expressed as e'_septal (mean: 6.9 (SD: 1.9) cm/s vs. 7.5 (2.4); P < 0.001) and E/e'_septal (median: 10.8 (interquartile range (IQR): 9.1–13.3) vs. 9.1 (7.2–11.1); P < 0.001) and global longitudinal strain (mean: − 14.1 (SD: 2.4) vs. − 15.0 (2.0), P < 0.001) but not with LV ejection fraction (median: 60.8 (IQR: 56.5–65.1) vs. 62.1 (57.9–65.4), P = 0.28). With the exception of global longitudinal strain, this was pronounced with increasing diabetes duration for all measures including increasing diastolic dysfunction (< 10 years: 10.8%, 10–20 years: 18.5%, > 20 years: 24.8%; P < 0.001). The increased risk of diastolic dysfunction persisted after multivariable adjustment (P = 0.013). Conclusions In patients with T2D, LV structural and functional alterations persist and are accentuated with increasing diabetes duration despite reductions in overall risk of cardiovascular disease in this patient population.

Originalsprog	Engelsk
Tidsskrift	International Journal of Cardiology
Vol/bind	221
Sider (fra-til)	114-21
Antal sider	8
ISSN	0167-5273
DOI	https://doi.org/10.1016/j.ijcard.2016.07.083
Status	Udgivet - 15 okt. 2016

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title = "Impact of type 2 diabetes and duration of type 2 diabetes on cardiac structure and function",

abstract = "Background Contemporary treatment of type 2 diabetes (T2D) has improved patient outcome and may also have affected myocardial structure and function. We aimed to describe the effect of T2D and T2D duration on cardiac structure and function in a large outpatient population. Methods We performed comprehensive echocardiography on a representative sample of 1004 persons including a representative sample of 770 patients with T2D without known heart disease and 234 age- and sex-matched controls. Results T2D was associated with increased left ventricular (LV) wall thicknesses and decreased LV internal diameter and the changes were pronounced with increasing diabetes duration (P < 0.01 for all) but not with increased LV mass (P = 0.74). It was also significantly associated with the prevalence of diastolic dysfunction (16.5% vs. 4.0%; P < 0.001), with indices of LV relaxation and elevated filling pressures expressed as e'septal (mean: 6.9 (SD: 1.9) cm/s vs. 7.5 (2.4); P < 0.001) and E/e'septal (median: 10.8 (interquartile range (IQR): 9.1–13.3) vs. 9.1 (7.2–11.1); P < 0.001) and global longitudinal strain (mean: − 14.1 (SD: 2.4) vs. − 15.0 (2.0), P < 0.001) but not with LV ejection fraction (median: 60.8 (IQR: 56.5–65.1) vs. 62.1 (57.9–65.4), P = 0.28). With the exception of global longitudinal strain, this was pronounced with increasing diabetes duration for all measures including increasing diastolic dysfunction (< 10 years: 10.8%, 10–20 years: 18.5%, > 20 years: 24.8%; P < 0.001). The increased risk of diastolic dysfunction persisted after multivariable adjustment (P = 0.013). Conclusions In patients with T2D, LV structural and functional alterations persist and are accentuated with increasing diabetes duration despite reductions in overall risk of cardiovascular disease in this patient population.",

keywords = "Journal Article",

author = "J{\o}rgensen, {Peter G} and Jensen, {Magnus T} and Rasmus Mogelvang and Hansen, {Thomas Fritz} and S{\o}ren Galatius and Tor Biering-S{\o}rensen and Heidi Storgaard and Lauritsen, {Tina Vilsb{\o}ll} and Peter Rossing and Jensen, {Jan S}",

year = "2016",

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doi = "10.1016/j.ijcard.2016.07.083",

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TY - JOUR

T1 - Impact of type 2 diabetes and duration of type 2 diabetes on cardiac structure and function

AU - Jørgensen, Peter G

AU - Jensen, Magnus T

AU - Mogelvang, Rasmus

AU - Hansen, Thomas Fritz

AU - Galatius, Søren

AU - Biering-Sørensen, Tor

AU - Storgaard, Heidi

AU - Lauritsen, Tina Vilsbøll

AU - Rossing, Peter

AU - Jensen, Jan S

PY - 2016/10/15

Y1 - 2016/10/15

N2 - Background Contemporary treatment of type 2 diabetes (T2D) has improved patient outcome and may also have affected myocardial structure and function. We aimed to describe the effect of T2D and T2D duration on cardiac structure and function in a large outpatient population. Methods We performed comprehensive echocardiography on a representative sample of 1004 persons including a representative sample of 770 patients with T2D without known heart disease and 234 age- and sex-matched controls. Results T2D was associated with increased left ventricular (LV) wall thicknesses and decreased LV internal diameter and the changes were pronounced with increasing diabetes duration (P < 0.01 for all) but not with increased LV mass (P = 0.74). It was also significantly associated with the prevalence of diastolic dysfunction (16.5% vs. 4.0%; P < 0.001), with indices of LV relaxation and elevated filling pressures expressed as e'septal (mean: 6.9 (SD: 1.9) cm/s vs. 7.5 (2.4); P < 0.001) and E/e'septal (median: 10.8 (interquartile range (IQR): 9.1–13.3) vs. 9.1 (7.2–11.1); P < 0.001) and global longitudinal strain (mean: − 14.1 (SD: 2.4) vs. − 15.0 (2.0), P < 0.001) but not with LV ejection fraction (median: 60.8 (IQR: 56.5–65.1) vs. 62.1 (57.9–65.4), P = 0.28). With the exception of global longitudinal strain, this was pronounced with increasing diabetes duration for all measures including increasing diastolic dysfunction (< 10 years: 10.8%, 10–20 years: 18.5%, > 20 years: 24.8%; P < 0.001). The increased risk of diastolic dysfunction persisted after multivariable adjustment (P = 0.013). Conclusions In patients with T2D, LV structural and functional alterations persist and are accentuated with increasing diabetes duration despite reductions in overall risk of cardiovascular disease in this patient population.

AB - Background Contemporary treatment of type 2 diabetes (T2D) has improved patient outcome and may also have affected myocardial structure and function. We aimed to describe the effect of T2D and T2D duration on cardiac structure and function in a large outpatient population. Methods We performed comprehensive echocardiography on a representative sample of 1004 persons including a representative sample of 770 patients with T2D without known heart disease and 234 age- and sex-matched controls. Results T2D was associated with increased left ventricular (LV) wall thicknesses and decreased LV internal diameter and the changes were pronounced with increasing diabetes duration (P < 0.01 for all) but not with increased LV mass (P = 0.74). It was also significantly associated with the prevalence of diastolic dysfunction (16.5% vs. 4.0%; P < 0.001), with indices of LV relaxation and elevated filling pressures expressed as e'septal (mean: 6.9 (SD: 1.9) cm/s vs. 7.5 (2.4); P < 0.001) and E/e'septal (median: 10.8 (interquartile range (IQR): 9.1–13.3) vs. 9.1 (7.2–11.1); P < 0.001) and global longitudinal strain (mean: − 14.1 (SD: 2.4) vs. − 15.0 (2.0), P < 0.001) but not with LV ejection fraction (median: 60.8 (IQR: 56.5–65.1) vs. 62.1 (57.9–65.4), P = 0.28). With the exception of global longitudinal strain, this was pronounced with increasing diabetes duration for all measures including increasing diastolic dysfunction (< 10 years: 10.8%, 10–20 years: 18.5%, > 20 years: 24.8%; P < 0.001). The increased risk of diastolic dysfunction persisted after multivariable adjustment (P = 0.013). Conclusions In patients with T2D, LV structural and functional alterations persist and are accentuated with increasing diabetes duration despite reductions in overall risk of cardiovascular disease in this patient population.

KW - Journal Article

U2 - 10.1016/j.ijcard.2016.07.083

DO - 10.1016/j.ijcard.2016.07.083

M3 - Journal article

C2 - 27423078

SN - 0167-5273

VL - 221

SP - 114

EP - 121

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Impact of type 2 diabetes and duration of type 2 diabetes on cardiac structure and function

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