Abstract 14811: Association of Cardiovascular Risk Factors and Myocardial Fibrosis with Early Cardiac Dysfunction in Type 1 Diabetes Mellitus: The Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Interventions and Complications (EDIC) Study
OBJECTIVE: We investigated the influence of cardiovascular (CV) risk factors and myocardial fibrosis on early cardiac dysfunction (impaired myocardial deformation) in persons with type 1 diabetes.
METHODS: We assessed 714 EDIC participants who had contrast-enhanced CMR examinations in 2008. EDIC cohort started in 1994 as a follow-up study of the DCCT (1983-1989). Late gadolinium enhancement-sequence was used to identify LV replacement fibrosis (scar) and then classified as ischemic or non-ischemic. Peak systolic circumferential strain (Ecc) at the mid-ventricular level was acquired from Tagging MRI sequences to assess myocardial deformation. Multiple linear regression models were used to assess associations of risk factors and myocardial scar with Ecc.
RESULTS: The mean age was 49±6 years and 58% were men. Myocardial deformation was lower (less negative value) in men, older participants, smokers, obese, and in those with hypertension and hypercholesterolemia. Impaired deformation was found in presence of myocardial scar, particularly in non-ischemic pattern (Table 1). After adjusting for machine type, age, gender, and study cohort, less circumferential deformation was significantly associated with smoking, higher BMI, and the mean values of higher blood pressure, lower HDL-cholesterol, and higher HbA1C and with non-ischemic myocardial scars (Table 2).
CONCLUSION: Traditional CV risk factors are related to subclinical cardiac dysfunction in type 1 diabetes. Presence of myocardial scar is associated with early dysfunction as a marker of chronic exposure to known risk factors and as an indicator of advanced diffuse cardiac damage, as seen in diabetic cardiomyopathy.
Author Disclosures: A.C. Armstrong: None. E. Turkbey: None. J. Backlund: None. B. Ambale-Venkatesh: None. S. Donekal: None. E. Chamera: None. P. Cleary: None. J. Lachin: None. D. Bluemke: None. J. Lima: Research Grant; Significant; Toshiba Medical Systems.
- © 2014 by American Heart Association, Inc.