PMID- 36494683
OWN - NLM
STAT- MEDLINE
DCOM- 20221216
LR  - 20230108
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 21
IP  - 1
DP  - 2022 Dec 9
TI  - Association of biomarkers and risk scores with subclinical left ventricular 
      dysfunction in patients with type 2 diabetes mellitus.
PG  - 278
LID - 10.1186/s12933-022-01711-5 [doi]
LID - 278
AB  - BACKGROUND: Subclinical LV dysfunction (LVD) identifies heart failure (HF) risk 
      in type 2 diabetes mellitus (T2DM). We sought the extent to which clinical scores 
      (ARIC-HF, WATCH-DM), natriuretic peptides (NTpBNP) and troponin (hs-TnT) were 
      associated with subclinical LV dysfunction (LVD). These associations could inform 
      the ability of these tests to identify which patients should undergo 
      echocardiography. METHODS: Participants with T2DM were prospectively recruited 
      from three community-based populations. ARIC-HF risk at 4 years and WATCH-DM 
      scores were calculated from clinical data. NTpBNP and hs-TnT were measured using 
      an electro-chemiluminescence assay. All underwent a comprehensive echocardiogram. 
      We calculated the sensitivity and specificity of clinical scores and biomarkers 
      to identify abnormal global longitudinal strain (GLS >/= -16%)), diastolic function 
      (E/e' >/= 14 or e' < 8 cm/s), left atrial volume index (LAV > 34 ml/m(2)) and LV 
      hypertrophy (LV mass index > 88 g/m(2) (F) > 102 g/m(2)(M)). RESULTS: Of 804 
      participants (median age 69 years [inter-quartile range (IQR) 65-73], 36% 
      female), clinical scores suggested significant HF risk (median ARIC-HF 8% [IQR 
      4-12]; WATCH-DM 10 points [IQR 8-12]), and the median NTpBNP was 50 pg/mL [IQR 
      25-101] and hs-TnT 9.6 pg/mL [IQR 6.8-13.6]. Abnormal GLS was present in 126 
      (17%), elevated E/e' in 114 (15%), impaired e' in 629 (78%), increased LAV in 351 
      (44%) and LV hypertrophy in 113 (14%). After adjustments for age, body-mass 
      index, and renal function, each standard deviation increase in NTpBNP was 
      associated with a GLS increase of 0.32 (p < 0.001) and hs-TnT increase by 0.26 
      (p < 0.001). Similar trends were observed with ARIC-HF (standardised beta = 0.22, 
      p < 0.001) and WATCH-DM (standardised beta = 0.22, p < 0.001) in univariable 
      analyses. However, none of the risk assessment tools provided satisfactory 
      discrimination for abnormal GLS (AUC 63%), diastolic indices (e' AUC 54-61%) or 
      LV mass (AUC 59-67%). At a sensitivity of 90%, there was an unacceptably low 
      (< 50%) specificity. CONCLUSION: Although risk assessment based on clinical 
      scores or biomarkers would be desirable to stratify HF risk in people with T2DM, 
      they show a weak relationship with subclinical LVD.
CI  - (c) 2022. The Author(s).
FAU - Halabi, Amera
AU  - Halabi A
AD  - (Dept) Imaging Research, Baker Heart and Diabetes Institute, 75 Commercial Road, 
      PO Box 6492, Melbourne, VIC, 3004, Australia.
AD  - School of Public Health and Preventive Medicine, Monash University, 553 St Kilda 
      Road, Melbourne, VIC, 3004, Australia.
FAU - Potter, Elizabeth
AU  - Potter E
AD  - (Dept) Imaging Research, Baker Heart and Diabetes Institute, 75 Commercial Road, 
      PO Box 6492, Melbourne, VIC, 3004, Australia.
AD  - School of Public Health and Preventive Medicine, Monash University, 553 St Kilda 
      Road, Melbourne, VIC, 3004, Australia.
FAU - Yang, Hilda
AU  - Yang H
AD  - (Dept) Imaging Research, Menzies Institute for Medical Research, 17 Liverpool 
      Street, Hobart, TAS, 7000, Australia.
FAU - Wright, Leah
AU  - Wright L
AD  - (Dept) Imaging Research, Baker Heart and Diabetes Institute, 75 Commercial Road, 
      PO Box 6492, Melbourne, VIC, 3004, Australia.
FAU - Sacre, Julian W
AU  - Sacre JW
AD  - (Dept) Imaging Research, Baker Heart and Diabetes Institute, 75 Commercial Road, 
      PO Box 6492, Melbourne, VIC, 3004, Australia.
FAU - Shaw, Jonathan E
AU  - Shaw JE
AD  - (Dept) Imaging Research, Baker Heart and Diabetes Institute, 75 Commercial Road, 
      PO Box 6492, Melbourne, VIC, 3004, Australia.
AD  - School of Public Health and Preventive Medicine, Monash University, 553 St Kilda 
      Road, Melbourne, VIC, 3004, Australia.
FAU - Marwick, Thomas H
AU  - Marwick TH
AD  - (Dept) Imaging Research, Baker Heart and Diabetes Institute, 75 Commercial Road, 
      PO Box 6492, Melbourne, VIC, 3004, Australia. tom.marwick@baker.edu.au.
AD  - School of Public Health and Preventive Medicine, Monash University, 553 St Kilda 
      Road, Melbourne, VIC, 3004, Australia. tom.marwick@baker.edu.au.
AD  - (Dept) Imaging Research, Menzies Institute for Medical Research, 17 Liverpool 
      Street, Hobart, TAS, 7000, Australia. tom.marwick@baker.edu.au.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221209
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
RN  - 0 (Biomarkers)
SB  - IM
MH  - Humans
MH  - Female
MH  - Aged
MH  - Male
MH  - *Diabetes Mellitus, Type 2/complications/diagnosis
MH  - Ventricular Function, Left
MH  - *Ventricular Dysfunction, Left/diagnostic imaging/etiology
MH  - Risk Factors
MH  - Diastole
MH  - Hypertrophy, Left Ventricular/diagnostic imaging/etiology
MH  - Biomarkers
MH  - *Heart Failure
MH  - Stroke Volume
PMC - PMC9737699
OTO - NOTNLM
OT  - Diabetes
OT  - Echocardiography
OT  - Heart failure
OT  - LV dysfunction
OT  - Natriuretic peptides
COIS- None.
EDAT- 2022/12/10 06:00
MHDA- 2022/12/15 06:00
PMCR- 2022/12/09
CRDT- 2022/12/09 23:55
PHST- 2022/09/11 00:00 [received]
PHST- 2022/11/30 00:00 [accepted]
PHST- 2022/12/09 23:55 [entrez]
PHST- 2022/12/10 06:00 [pubmed]
PHST- 2022/12/15 06:00 [medline]
PHST- 2022/12/09 00:00 [pmc-release]
AID - 10.1186/s12933-022-01711-5 [pii]
AID - 1711 [pii]
AID - 10.1186/s12933-022-01711-5 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2022 Dec 9;21(1):278. doi: 10.1186/s12933-022-01711-5.