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

Figures & data

Figure 1 Study protocol. At baseline 300 participants with diabetes mellitus were recruited; 45 subjects were excluded and reasons for ineligibility are shown. A total of 255 subjects with T2DM were finally included in the analyses.

Abbreviations: eGFR, estimated glomerular filtration; T2DM, type 2 diabetes mellitus.

Table 1 Demographic, Anthropometric, Biochemical and Subclinical Cardiovascular Diseases Characteristics

Clinical Characteristics	n=255
Age, y, mean (SD)	49.82 (12.28)
Male, n (%)	177 (69.4)
BMI, kg/m², mean (SD)	27.16 (5.05)
Current smokers, n (%)	119 (46.7)
Alcohol intake, n (%)	77 (30.2)
SBP, mmHg, mean (SD)	127.55 (15.44)
DBP, mmHg, mean (SD)	80.70 (10.20)
Hypertension, n (%)	118 (46.3)
DM, y, median (IQR)	5.00 (1.00,11.00)
2h-blood glucose, mmol/L, mean (SD)	18.46 (3.61)
2h-insulin, mIU/L, mean (SD)†	1.54 (0.35)
HOMA-IR, mean (SD)†	0.49 (0.36)
HbA1c (%), mean (SD)	9.52 (1.97)
Triglyceride, mmol/L, mean (SD)^†	0.28 (0.28)
Total cholesterol, mmol/L, mean (SD)	4.86 (1.24)
LDL-C, mmol/L, mean (SD)	2.67 (0.87)
HDL-C, mmol/L, mean (SD)	1.11 (0.27)
Subclinical cardiovascular disease measures
ABI, mean (SD)	1.15 (0.08)
baPWV, m/s, mean (SD)	13.40 (2.14)
cfPWV, m/s, mean (SD)	9.24 (1.78)
cIMT, mm, median (IQR)	1.00 (0.90,1.00)
Plaque, n (%)	133 (52.2)

Note: ^†lg-transformed.

Abbreviations: IQR, interquartile range; SD, standerd deviation; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; DM, diabetes mellitus; HOMA-IR, homeostasis model assessment of insulin resistance; LDL-C, low-density lipoprotein cholesterol; HDL-C high-density lipoprotein cholesterol; ABI, ankle brachial index; baPWV, brachial artery pulse wave velocity; cfPWV, carotid-femoral pulse wave velocity; cIMT, carotid intima-media thickness.

Table 2 Cardiac Morpho-Functional Parameters

Echocardiographic Characteristics	N=255
LVEF, %, mean (SD)	68.32 (4.57)
IVSDT, cm, mean (SD)	1.00 (0.13)
LVEDD, cm, mean (SD)	4.67 (0.34)
LVPWT, cm, mean (SD)	1.00 (0.13)
LVM, g, mean (SD)	158.09 (40.16)
LVMI, g/m³, mean (SD)	85.57 (15.91)
RWT, mean (SD)	0.41 (0.06)
Peak E/A, mean (SD)	1.04 (034)

Abbreviations: LVEF, left ventricular ejection fraction; IVSDT, inter ventricular septal diastolic thickness; LVEDD, left ventricular end-diastolic diameter; LVPWT, left ventricular posterior wall thickness; LVM, left ventricular mass; LVMI, left ventricular mass index; RWT, relative wall thickness.

Table 3 Correlation Between Clinical, Subclinical Cardiovascular Diseases Characteristics and Cardiac Parameters

	LVMI		RWT		LVEF		Peak E/A
	r	p	r	p	r	p	r	p
Gender	0.166	0.008	−0.023	0.715	0.071	0.261	−0.155	0.013
Age	0.376	0.000	0.079	0.207	0.082	0.191	−0.538	0.000
BMI	−0.075	0.235	−0.066	0.297	0.030	0.628	0.204	0.001
SBP	0.220	0.000	−0.001	0.994	−0.025	0.688	−0.226	0.000
DBP	0.036	0.565	−0.008	0.902	0.044	0.485	−0.120	0.055
DM, y	0.181	0.004	0.091	0.149	−0.012	0.847	−0.276	0.000
ABI	0.019	0.765	−0.118	0.060	−0.112	0.073	0.052	0.408
baPWV	0.106	0.091	0.103	0.101	0.047	0.452	−0.337	0.000
cfPWV	0.193	0.002	0.143	0.022	0.052	0.405	−0.418	0.000
cIMT	0.030	0.633	−0.036	0.567	−0.147	0.019	0.030	0.633
plaque	0.173	0.006	0.112	0.075	0.064	0.308	−0.317	0.000

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; DM, diabetes mellitus; ABI, ankle brachial index; baPWV, brachial artery pulse wave velocity; cfPWV, carotid-femoral pulse wave velocity; cIMT, carotid intima-media thickness; LVMI, left ventricular mass index; RWT, relative wall thickness; LVEF, left ventricular ejection fraction.

Table 4 Multivariable Associations Between Clinical, Subclinical Cardiovascular Diseases Characteristics and Cardiac Parameters

	β	SEM	p-value	R²
LVMI
Age	0.463	0.075	0.000	0.186
SBP	0.179	0.060	0.003
2h-insulin	−0.024	0.010	0.019
RWT
cfPWV	0.006	0.002	0.007	0.037
HOMA-IR	0.000	0.000	0.036
LVEF
cIMT	−0.925	0.392	0.019	0.022
Peak E/A
Age	−0.014	0.002	0.000	0.289
DBP	−0.006	0.002	0.001
cfPWV	−0.025	0.012	0.044

Abbreviations: LVMI, left ventricular mass index; SBP, systolic blood pressure; RWT, relative wall thickness; cfPWV, carotid-femoral pulse wave velocity; HOMA-IR, homeostasis model assessment of insulin resistance; LVEF, left ventricular ejection fraction; cIMT, carotid intima-media thickness; DBP, diastolic blood pressure.