Relationship Between Subclinical Cardiovascular Diseases and Cardiac Morpho-Functional Parameters in Preclinical Stage A/B Heart Failure Adults with Type 2 Diabetes

Abstract

Purpose

Type 2 diabetes mellitus (T2DM) is a common risk factor for cardiovascular disease which increases the risk of heart failure. This study aimed to determine whether clinical characteristics and subclinical cardiovascular disease (CVD) features are correlated with echocardiographic morpho-functional parameters of T2DM patients.

Patients and Methods

Two hundred and fifty-five T2DM patients without a history of coronary heart disease were enrolled in this cross-sectional study. The demographic characteristics, glucose and lipid levels were assessed for each patient. Carotid ultrasonography and peripheral artery examination were performed to measure carotid intima-media thickness (cIMT), carotid plaque, ankle-brachial index (ABI), brachial artery pulse wave velocity (baPWV), and carotid-femoral pulse wave velocity (cfPWV). Furthermore, echocardiography was conducted to evaluate cardiac morphology and systolic and diastolic function. The relationship between clinical characteristics, subclinical cardiovascular diseases, and cardiac morpho-functional parameters was explored with the Pearson and stepwise multivariable linear regression analyses.

Results

A total of 255 subjects aged 18–80 years were enrolled in the study. Multiple regression analysis revealed that left ventricular mass index (LVMI) was correlated with age (β=0.463, p = 0.000) and systolic blood pressure (SBP) (β=0.179, p = 0.003). Relative wall thickness (RWT) was related to cfPWV (β=0.006, p = 0.007) and homeostasis model assessment of insulin resistance (HOMA-IR) (β=0.000, p = 0.036). In contrast, left ventricular ejection fraction (LVEF) was inversely related to cIMT (β=−0.925, p = 0.019). The ratio of the peak flow velocity of early diastole to atrial contraction (peak E/A) was correlated with age (β=−0.014, p = 0.000), diastolic blood pressure (DBP) (β=−0.006, p = 0.001) and cfPWV (β=−0.025, p = 0.044).

Conclusion

In preclinical stage A/B heart failure adults with T2DM, age, BP, HOMA-IR, cfPWV and cIMT are correlated with cardiac morpho-functional parameters.

Keywords:

• type 2 diabetes mellitus
• preclinical stage A/B heart failure
• subclinical cardiovascular diseases
• echocardiography

Data Sharing Statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethical Approval

Our research has been approved by the ethics review board of Peking Union Medical Hospital, China. The ID of the approval was J5-2564. Informed consent for participation was obtained in this study. All procedures performed in the study involving human participants were in accordance with the Helsinki declaration and its later amendments or comparable ethical standards.

Consent to Publication

The authors declare that we agree to the publication of the detail of article.

Acknowledgment

We are grateful to Dr Yonghui Wang for help in the implementation of this study.

Disclosure

The authors declare that there is no conflict of interests.

Additional information

Funding

The work was supported by a grant from the Capital health research and development of special (No. 2020-2Z-40117).