In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to HFA Silver & Gold Members, Fellows of the ESC and Young combined Members

Left ventricular systolic dysfunction in asymptomatic patients with diabetes mellitus type 1 is associated with duration of disease, obesity and poor glycemic control

Session Poster Session 3

Speaker Chris Kapelios

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : C Kapelios (Athens,GR), S Liatis (Athens,GR), M Bonou (Athens,GR), A Tentolouris (Athens,GR), A Barmpagianni (Athens,GR), M Driva (Athens,GR), I Eleftheriadou (Athens,GR), E Papachristoforou (Athens,GR), E Athanasiadi (Athens,GR), D Tsilingiris (Athens,GR), V Lambadiari (Athens,GR), J Barbetseas (Athens,GR)

Authors:
C Kapelios1 , S Liatis1 , M Bonou1 , A Tentolouris1 , A Barmpagianni1 , M Driva1 , I Eleftheriadou1 , E Papachristoforou1 , E Athanasiadi1 , D Tsilingiris1 , V Lambadiari2 , J Barbetseas1 , 1Laiko University General Hospital - Athens - Greece , 2Attikon University Hospital - Athens - Greece ,

Citation:

Background: Diabetes mellitus type 1 (DM1) primarily affects children and young, otherwise healthy, individuals. Cardiomyopathy presenting in these patients is mainly attributed to the direct effect of hyperglycemia. Pre-symptomatic diagnosis of myocardial dysfunction could facilitate timely and effective implementation of therapeutic interventions. However, the prevalence and risk factors of pre-symptomatic left ventricular systolic dysfunction (LVSD) in individuals with DM1 have not been systematically studied.

Purpose: To investigate the prevalence and risk factors for LVSD in asymptomatic patients with DM1.

Methods: We studied the association between presence of LVSD, assessed by abnormal values of global longitudinal strain (GLS), and a) patient history, b) demographic and clinical characteristics, c) autonomic nervous system function, measured using the battery of the 4 standardized tests proposed by Ewing, d) arterial stiffness, assessed by calculation of pulse wave velocity between the carotid and common femoral artery, e) body lipometry and f) prevalence and severity of diabetic complications in patients with DM1 and no history of cardiovascular disease. Results: We prospectively enrolled one hundred and forty-one asymptomatic patients with DM1. Forty-one (29.1%) were men, while mean age, disease duration and glycated hemoglobin were 37.6 ± 13.0 years, 19.2 ± 9.8 years and 7.4 ± 1.4%, respectively. LVSD, defined as a value of GLS> -19.6%, was prevalent in 65/141 (46.1%) patients. Patients with LVSD had a longer history of DM (21.0 ± 9.3 vs. 17.6 ± 10.1 years, P=0.045), a higher body mass index (BMI) (26.9 ± 5.1 vs. 24.3 ± 4.4 kg/m2, P=0.001) and higher levels of blood glycated hemoglobin (7.8 ± 1.5 vs. 7.1 ± 1.2%, P=0.007) compared with patients without LVSD.

In multivariable analysis, glycated hemoglobin levels (OR: 1.54; 95% CI: 1.11-2.13, P=0.011), duration of DM1 (OR: 1.05; 95% CI: 1.01-1.10, P=0.035), and waist circumference (WC, OR: 1.04; 95% CI: 1.01-1.07, P=0.015) or body mass index (BMI, used interchangeably with WC, OR: 1.11; 95% CI: 1.02-1.21, P=0.023) were independently associated with the presence of LVSD.

Conclusions: Our results indicate that apart from chronic hyperglycemia, increased adiposity, possibly indicating a dysmetabolic state, as expressed by a higher BMI/WC, may be implicated in the pathogenesis of LVSD, which leads to diabetic cardiomyopathy in patients with DM1. Interventions leading to weight loss could be considered as a therapeutic target to potentially prevent or/and reverse LVSD in these patients.

The free consultation period for this content is over.

It is now only available year-round to HFA Silver & Gold Members, Fellows of the ESC and Young combined Members

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are