Relation of Aortic Stiffness to Left Ventricular Remodeling in Younger Adults With Type 2 Diabetes

• Published in: Diabetes (New York, N.Y.) Vol. 67; no. 7; pp. 1395 - 1400
• Main Authors: Gulsin, Gaurav S, Swarbrick, Daniel J, Hunt, William H, Levelt, Eylem, Graham-Brown, Matthew P M, Parke, Kelly S, Wormleighton, Joanne V, Lai, Florence Y, Yates, Thomas, Wilmot, Emma G, Webb, David R, Davies, Melanie J, McCann, Gerry P
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.07.2018
• Subjects: Adolescent; Adult; Aged; Aorta; Aortic Diseases - diagnosis; Aortic Diseases - epidemiology; Aortic Diseases - etiology; Aortic Diseases - physiopathology; Cardiomyopathy; Cardiovascular diseases; Case-Control Studies; Coronary vessels; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Cardiomyopathies - diagnosis; Diabetic Cardiomyopathies - epidemiology; Diabetic Cardiomyopathies - physiopathology; Female; Heart diseases; Heart failure; Humans; Hypertrophy, Left Ventricular - complications; Hypertrophy, Left Ventricular - diagnosis; Hypertrophy, Left Ventricular - epidemiology; Magnetic Resonance Imaging; Male; Middle Aged; NMR; Nuclear magnetic resonance; Risk Factors; Therapeutic applications; Vascular Stiffness - physiology; Ventricle; Ventricular Remodeling - physiology; Young Adult; Young adults
• DOI: 10.2337/db18-0112
• ISSN: 0012-1797

Individuals with type 2 diabetes have a three- to fivefold increased risk of developing heart failure. Diabetic cardiomyopathy is typified by left ventricular (LV) concentric remodeling, which is a recognized predictor of adverse cardiovascular events. Although the mechanisms underlying LV remodeling in type 2 diabetes are unclear, progressive aortic stiffening may be a key determinant. The aim of this study was to assess the relationship between aortic stiffness and LV geometry in younger adults with type 2 diabetes, using multiparametric cardiovascular MRI. We prospectively recruited 80 adults (aged 18-65 years) with type 2 diabetes and no cardiovascular disease and 20 age- and sex-matched healthy control subjects. All subjects underwent comprehensive bio-anthropometric assessment and cardiac MRI, including measurement of aortic stiffness by aortic distensibility (AD). Type 2 diabetes was associated with increased LV mass, concentric LV remodeling, and lower AD compared with control subjects. On multivariable linear regression, AD was independently associated with concentric LV remodeling in type 2 diabetes. Aortic stiffness may therefore be a potential therapeutic target to prevent the development of heart failure in type 2 diabetes.