Poor Glycemic Control Is Associated With Increased Extracellular Volume Fraction in Diabetes
| Autor: | Amer Ahmed Syed, Bilal Ansari, Scott Akers, Khuzaima Javaid, Ahmed AlBadri, Swetha Gaddam, Walter R Witschey, Zeba Hashmath, Julio A. Chirinos, Rachana Miller, Garrett Oldland |
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| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
Male Cardiovascular and Metabolic Risk medicine.medical_specialty Diabetic Cardiomyopathies Endocrinology Diabetes and Metabolism Renal function 030209 endocrinology & metabolism Type 2 diabetes 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Fibrosis Internal medicine Diabetes mellitus Internal Medicine Humans Medicine Aged Glycemic Glycated Hemoglobin Advanced and Specialized Nursing business.industry Myocardium Stroke Volume Stroke volume Middle Aged medicine.disease Magnetic Resonance Imaging Blood pressure Diabetes Mellitus Type 2 Cardiology Female Myocardial fibrosis Cardiomyopathies business |
| Zdroj: | Diabetes Care. 41:2019-2025 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc18-0324 |
| Popis: | OBJECTIVE We assessed whether poor glycemic control is associated with an increase in myocardial fibrosis among adults with diabetes. RESEARCH DESIGN AND METHODS We studied 47 adults with type 2 diabetes and stratified them into three groups according to their hemoglobin A1c (HbA1c) level: 7.5% (group 3; n = 15). Left ventricular (LV) mass was assessed using cardiac MRI. The extracellular volume fraction (ECVF), an index of myocardial fibrosis, was measured by using myocardial T1 mapping before and after the administration of a gadolinium-based contrast agent. RESULTS Mean HbA1c was 5.84 ± 0.16%, 6.89 ± 0.14%, and 8.57 ± 0.2% in groups 1, 2, and 3, respectively. LV mass was not significantly different between the groups. The myocardial ECVF was significantly greater in groups 2 (mean 27.6% [95% CI 24.8–30.3]) and 3 (27.6% [24.4–30.8]) than in group 1 (21.1% [17.5–24.7]; P = 0.015). After adjusting for age, sex, BMI, blood pressure, and estimated glomerular filtration rate, the myocardial ECVF was significantly greater in groups 2 (27.4% [24.4–30.4]) and 3 (28% [24.5–31.5]) than in group 1 (20.9% [17.1–24.6]; P = 0.0156, ANCOVA). CONCLUSIONS An increased myocardial ECVF, suggesting myocardial fibrosis, is independently associated with poor glycemic control among adults with diabetes. Further research should assess whether tight glycemic control can revert fibrosis to healthy myocardium or ameliorate it and its adverse clinical consequences. |
| Databáze: | OpenAIRE |
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