suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease

Simone Theilade; Peter Rossing; Jesper Eugen-Olsen; Jan S Jensen; Magnus T Jensen

doi:10.1530/eje-15-0986

suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease

Simone Theilade, Peter Rossing, Jesper Eugen-Olsen, Jan S Jensen, Magnus T Jensen

Institut for Klinisk Medicin

13 Citationer (Scopus)

Abstract

AIM: Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods.

METHODS: In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates.

RESULTS: Patients were 55±12 years (mean±s.d.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58±5%. suPAR levels were not associated with LVEF (P=0.11). In adjusted models, higher suPAR levels were independently associated with both impaired systolic function assessed with global longitudinal strain (GLS) and tissue velocity s', and with impaired diastolic measures a' and e'/a' (all P=0.034). In multivariable analysis including cardiovascular risk factors and both systolic and diastolic measures (GLS and e'/a'), both remained independently associated with suPAR levels (P=0.012).

CONCLUSIONS: In patients with type 1 diabetes with normal LVEF and without known heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy.

Originalsprog	Engelsk
Tidsskrift	European Journal of Endocrinology
Vol/bind	174
Udgave nummer	6
Sider (fra-til)	745-53
Antal sider	9
ISSN	0804-4643
DOI	https://doi.org/10.1530/eje-15-0986
Status	Udgivet - jun. 2016

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Citationsformater

Theilade, S., Rossing, P., Eugen-Olsen, J., Jensen, J. S., & Jensen, M. T. (2016). suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease. European Journal of Endocrinology, 174(6), 745-53. https://doi.org/10.1530/eje-15-0986

suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease. / Theilade, Simone; Rossing, Peter; Eugen-Olsen, Jesper et al.

I: European Journal of Endocrinology, Bind 174, Nr. 6, 06.2016, s. 745-53.

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

Theilade, S, Rossing, P, Eugen-Olsen, J, Jensen, JS & Jensen, MT 2016, 'suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease', European Journal of Endocrinology, bind 174, nr. 6, s. 745-53. https://doi.org/10.1530/eje-15-0986

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title = "suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease",

abstract = "AIM: Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods.METHODS: In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates.RESULTS: Patients were 55±12 years (mean±s.d.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58±5%. suPAR levels were not associated with LVEF (P=0.11). In adjusted models, higher suPAR levels were independently associated with both impaired systolic function assessed with global longitudinal strain (GLS) and tissue velocity s', and with impaired diastolic measures a' and e'/a' (all P=0.034). In multivariable analysis including cardiovascular risk factors and both systolic and diastolic measures (GLS and e'/a'), both remained independently associated with suPAR levels (P=0.012).CONCLUSIONS: In patients with type 1 diabetes with normal LVEF and without known heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy.",

keywords = "Adult, Aged, Diabetes Mellitus, Type 1, Echocardiography, Female, Heart, Humans, Kidney Failure, Chronic, Male, Middle Aged, Receptors, Urokinase Plasminogen Activator, Risk Factors, Ventricular Dysfunction, Left, Journal Article",

author = "Simone Theilade and Peter Rossing and Jesper Eugen-Olsen and Jensen, {Jan S} and Jensen, {Magnus T}",

note = "{\textcopyright} 2016 European Society of Endocrinology.",

year = "2016",

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doi = "10.1530/eje-15-0986",

language = "English",

volume = "174",

pages = "745--53",

journal = "European Journal of Endocrinology",

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TY - JOUR

T1 - suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease

AU - Theilade, Simone

AU - Rossing, Peter

AU - Eugen-Olsen, Jesper

AU - Jensen, Jan S

AU - Jensen, Magnus T

PY - 2016/6

Y1 - 2016/6

N2 - AIM: Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods.METHODS: In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates.RESULTS: Patients were 55±12 years (mean±s.d.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58±5%. suPAR levels were not associated with LVEF (P=0.11). In adjusted models, higher suPAR levels were independently associated with both impaired systolic function assessed with global longitudinal strain (GLS) and tissue velocity s', and with impaired diastolic measures a' and e'/a' (all P=0.034). In multivariable analysis including cardiovascular risk factors and both systolic and diastolic measures (GLS and e'/a'), both remained independently associated with suPAR levels (P=0.012).CONCLUSIONS: In patients with type 1 diabetes with normal LVEF and without known heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy.

AB - AIM: Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods.METHODS: In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates.RESULTS: Patients were 55±12 years (mean±s.d.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58±5%. suPAR levels were not associated with LVEF (P=0.11). In adjusted models, higher suPAR levels were independently associated with both impaired systolic function assessed with global longitudinal strain (GLS) and tissue velocity s', and with impaired diastolic measures a' and e'/a' (all P=0.034). In multivariable analysis including cardiovascular risk factors and both systolic and diastolic measures (GLS and e'/a'), both remained independently associated with suPAR levels (P=0.012).CONCLUSIONS: In patients with type 1 diabetes with normal LVEF and without known heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy.

KW - Adult

KW - Aged

KW - Diabetes Mellitus, Type 1

KW - Echocardiography

KW - Female

KW - Heart

KW - Humans

KW - Kidney Failure, Chronic

KW - Male

KW - Middle Aged

KW - Receptors, Urokinase Plasminogen Activator

KW - Risk Factors

KW - Ventricular Dysfunction, Left

KW - Journal Article

U2 - 10.1530/eje-15-0986

DO - 10.1530/eje-15-0986

M3 - Journal article

C2 - 26951602

SN - 0804-4643

VL - 174

SP - 745

EP - 753

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

IS - 6

ER -