Changes in Cardiac Morphology and Function in Individuals With Diabetes Mellitus: The UK Biobank Cardiovascular Magnetic Resonance Substudy

Magnus T. Jensen; Kenneth Fung; Nay Aung; Mihir M. Sanghvi; Sucharitha Chadalavada; Jose M. Paiva; Mohammed Y. Khanji; Martina C. de Knegt; Elena Lukaschuk; Aaron M. Lee; Ahmet Barutcu; Edd Maclean; Valentina Carapella; Jackie Cooper; Alistair Young; Stefan K. Piechnik; Stefan Neubauer; Steffen E. Petersen

doi:10.1161/CIRCIMAGING.119.009476

Changes in Cardiac Morphology and Function in Individuals With Diabetes Mellitus: The UK Biobank Cardiovascular Magnetic Resonance Substudy

Magnus T. Jensen, Kenneth Fung, Nay Aung, Mihir M. Sanghvi, Sucharitha Chadalavada, Jose M. Paiva, Mohammed Y. Khanji, Martina C. de Knegt, Elena Lukaschuk, Aaron M. Lee, Ahmet Barutcu, Edd Maclean, Valentina Carapella, Jackie Cooper, Alistair Young, Stefan K. Piechnik, Stefan Neubauer, Steffen E. Petersen

Biomedical Engineering Department

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND: Diabetes mellitus (DM) is associated with increased risk of cardiovascular disease. Detection of early cardiac changes before manifest disease develops is important. We investigated early alterations in cardiac structure and function associated with DM using cardiovascular magnetic resonance imaging. METHODS: Participants from the UK Biobank Cardiovascular Magnetic Resonance Substudy, a community cohort study, without known cardiovascular disease and left ventricular ejection fraction ≥50% were included. Multivariable linear regression models were performed. The investigators were blinded to DM status. RESULTS: A total of 3984 individuals, 45% men, (mean [SD]) age 61.3 (7.5) years, hereof 143 individuals (3.6%) with DM. There was no difference in left ventricular (LV) ejection fraction (DM versus no DM; coefficient [95% CI]: -0.86% [-1.8 to 0.5]; P=0.065), LV mass (-0.13 g/m2 [-1.6 to 1.3], P=0.86), or right ventricular ejection fraction (-0.23% [-1.2 to 0.8], P=0.65). However, both LV and right ventricular volumes were significantly smaller in DM, (LV end-diastolic volume/m2: -3.46 mL/m2 [-5.8 to -1.2], P=0.003, right ventricular end-diastolic volume/m2: -4.2 mL/m2 [-6.8 to -1.7], P=0.001, LV stroke volume/m2: -3.0 mL/m2 [-4.5 to -1.5], P<0.001; right ventricular stroke volume/m2: -3.8 mL/m2 [-6.5 to -1.1], P=0.005), LV mass/volume: 0.026 (0.01 to 0.04) g/mL, P=0.006. Both left atrial and right atrial emptying fraction were lower in DM (right atrial emptying fraction: -6.2% [-10.2 to -2.1], P=0.003; left atrial emptying fraction:-3.5% [-6.9 to -0.1], P=0.043). LV global circumferential strain was impaired in DM (coefficient [95% CI]: 0.38% [0.01 to 0.7], P=0.045). CONCLUSIONS: In a low-risk general population without known cardiovascular disease and with preserved LV ejection fraction, DM is associated with early changes in all 4 cardiac chambers. These findings suggest that diabetic cardiomyopathy is not a regional condition of the LV but affects the heart globally.

Original language	English
Pages (from-to)	e009476
Journal	Circulation. Cardiovascular imaging
Volume	12
Issue number	9
DOIs	https://doi.org/10.1161/CIRCIMAGING.119.009476
Publication status	Published - 1 Sept 2019

Keywords

cardiomyopathies
cardiovascular
diabetes mellitus
heart disease
magnetic resonance imaging

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1161/CIRCIMAGING.119.009476

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Jensen, M. T., Fung, K., Aung, N., Sanghvi, M. M., Chadalavada, S., Paiva, J. M., Khanji, M. Y., de Knegt, M. C., Lukaschuk, E., Lee, A. M., Barutcu, A., Maclean, E., Carapella, V., Cooper, J., Young, A., Piechnik, S. K., Neubauer, S., & Petersen, S. E. (2019). Changes in Cardiac Morphology and Function in Individuals With Diabetes Mellitus: The UK Biobank Cardiovascular Magnetic Resonance Substudy. Circulation. Cardiovascular imaging, 12(9), e009476. https://doi.org/10.1161/CIRCIMAGING.119.009476

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title = "Changes in Cardiac Morphology and Function in Individuals With Diabetes Mellitus: The UK Biobank Cardiovascular Magnetic Resonance Substudy",

abstract = "BACKGROUND: Diabetes mellitus (DM) is associated with increased risk of cardiovascular disease. Detection of early cardiac changes before manifest disease develops is important. We investigated early alterations in cardiac structure and function associated with DM using cardiovascular magnetic resonance imaging. METHODS: Participants from the UK Biobank Cardiovascular Magnetic Resonance Substudy, a community cohort study, without known cardiovascular disease and left ventricular ejection fraction ≥50% were included. Multivariable linear regression models were performed. The investigators were blinded to DM status. RESULTS: A total of 3984 individuals, 45% men, (mean [SD]) age 61.3 (7.5) years, hereof 143 individuals (3.6%) with DM. There was no difference in left ventricular (LV) ejection fraction (DM versus no DM; coefficient [95% CI]: -0.86% [-1.8 to 0.5]; P=0.065), LV mass (-0.13 g/m2 [-1.6 to 1.3], P=0.86), or right ventricular ejection fraction (-0.23% [-1.2 to 0.8], P=0.65). However, both LV and right ventricular volumes were significantly smaller in DM, (LV end-diastolic volume/m2: -3.46 mL/m2 [-5.8 to -1.2], P=0.003, right ventricular end-diastolic volume/m2: -4.2 mL/m2 [-6.8 to -1.7], P=0.001, LV stroke volume/m2: -3.0 mL/m2 [-4.5 to -1.5], P<0.001; right ventricular stroke volume/m2: -3.8 mL/m2 [-6.5 to -1.1], P=0.005), LV mass/volume: 0.026 (0.01 to 0.04) g/mL, P=0.006. Both left atrial and right atrial emptying fraction were lower in DM (right atrial emptying fraction: -6.2% [-10.2 to -2.1], P=0.003; left atrial emptying fraction:-3.5% [-6.9 to -0.1], P=0.043). LV global circumferential strain was impaired in DM (coefficient [95% CI]: 0.38% [0.01 to 0.7], P=0.045). CONCLUSIONS: In a low-risk general population without known cardiovascular disease and with preserved LV ejection fraction, DM is associated with early changes in all 4 cardiac chambers. These findings suggest that diabetic cardiomyopathy is not a regional condition of the LV but affects the heart globally.",

keywords = "cardiomyopathies, cardiovascular, diabetes mellitus, heart disease, magnetic resonance imaging",

author = "Jensen, {Magnus T.} and Kenneth Fung and Nay Aung and Sanghvi, {Mihir M.} and Sucharitha Chadalavada and Paiva, {Jose M.} and Khanji, {Mohammed Y.} and {de Knegt}, {Martina C.} and Elena Lukaschuk and Lee, {Aaron M.} and Ahmet Barutcu and Edd Maclean and Valentina Carapella and Jackie Cooper and Alistair Young and Piechnik, {Stefan K.} and Stefan Neubauer and Petersen, {Steffen E.}",

year = "2019",

month = sep,

day = "1",

doi = "10.1161/CIRCIMAGING.119.009476",

language = "English",

volume = "12",

pages = "e009476",

journal = "Circulation. Cardiovascular imaging",

issn = "1941-9651",

publisher = "Lippincott Williams and Wilkins",

number = "9",

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Jensen, MT, Fung, K, Aung, N, Sanghvi, MM, Chadalavada, S, Paiva, JM, Khanji, MY, de Knegt, MC, Lukaschuk, E, Lee, AM, Barutcu, A, Maclean, E, Carapella, V, Cooper, J, Young, A, Piechnik, SK, Neubauer, S & Petersen, SE 2019, 'Changes in Cardiac Morphology and Function in Individuals With Diabetes Mellitus: The UK Biobank Cardiovascular Magnetic Resonance Substudy', Circulation. Cardiovascular imaging, vol. 12, no. 9, pp. e009476. https://doi.org/10.1161/CIRCIMAGING.119.009476

TY - JOUR

T1 - Changes in Cardiac Morphology and Function in Individuals With Diabetes Mellitus

T2 - The UK Biobank Cardiovascular Magnetic Resonance Substudy

AU - Jensen, Magnus T.

AU - Fung, Kenneth

AU - Aung, Nay

AU - Sanghvi, Mihir M.

AU - Chadalavada, Sucharitha

AU - Paiva, Jose M.

AU - Khanji, Mohammed Y.

AU - de Knegt, Martina C.

AU - Lukaschuk, Elena

AU - Lee, Aaron M.

AU - Barutcu, Ahmet

AU - Maclean, Edd

AU - Carapella, Valentina

AU - Cooper, Jackie

AU - Young, Alistair

AU - Piechnik, Stefan K.

AU - Neubauer, Stefan

AU - Petersen, Steffen E.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - BACKGROUND: Diabetes mellitus (DM) is associated with increased risk of cardiovascular disease. Detection of early cardiac changes before manifest disease develops is important. We investigated early alterations in cardiac structure and function associated with DM using cardiovascular magnetic resonance imaging. METHODS: Participants from the UK Biobank Cardiovascular Magnetic Resonance Substudy, a community cohort study, without known cardiovascular disease and left ventricular ejection fraction ≥50% were included. Multivariable linear regression models were performed. The investigators were blinded to DM status. RESULTS: A total of 3984 individuals, 45% men, (mean [SD]) age 61.3 (7.5) years, hereof 143 individuals (3.6%) with DM. There was no difference in left ventricular (LV) ejection fraction (DM versus no DM; coefficient [95% CI]: -0.86% [-1.8 to 0.5]; P=0.065), LV mass (-0.13 g/m2 [-1.6 to 1.3], P=0.86), or right ventricular ejection fraction (-0.23% [-1.2 to 0.8], P=0.65). However, both LV and right ventricular volumes were significantly smaller in DM, (LV end-diastolic volume/m2: -3.46 mL/m2 [-5.8 to -1.2], P=0.003, right ventricular end-diastolic volume/m2: -4.2 mL/m2 [-6.8 to -1.7], P=0.001, LV stroke volume/m2: -3.0 mL/m2 [-4.5 to -1.5], P<0.001; right ventricular stroke volume/m2: -3.8 mL/m2 [-6.5 to -1.1], P=0.005), LV mass/volume: 0.026 (0.01 to 0.04) g/mL, P=0.006. Both left atrial and right atrial emptying fraction were lower in DM (right atrial emptying fraction: -6.2% [-10.2 to -2.1], P=0.003; left atrial emptying fraction:-3.5% [-6.9 to -0.1], P=0.043). LV global circumferential strain was impaired in DM (coefficient [95% CI]: 0.38% [0.01 to 0.7], P=0.045). CONCLUSIONS: In a low-risk general population without known cardiovascular disease and with preserved LV ejection fraction, DM is associated with early changes in all 4 cardiac chambers. These findings suggest that diabetic cardiomyopathy is not a regional condition of the LV but affects the heart globally.

AB - BACKGROUND: Diabetes mellitus (DM) is associated with increased risk of cardiovascular disease. Detection of early cardiac changes before manifest disease develops is important. We investigated early alterations in cardiac structure and function associated with DM using cardiovascular magnetic resonance imaging. METHODS: Participants from the UK Biobank Cardiovascular Magnetic Resonance Substudy, a community cohort study, without known cardiovascular disease and left ventricular ejection fraction ≥50% were included. Multivariable linear regression models were performed. The investigators were blinded to DM status. RESULTS: A total of 3984 individuals, 45% men, (mean [SD]) age 61.3 (7.5) years, hereof 143 individuals (3.6%) with DM. There was no difference in left ventricular (LV) ejection fraction (DM versus no DM; coefficient [95% CI]: -0.86% [-1.8 to 0.5]; P=0.065), LV mass (-0.13 g/m2 [-1.6 to 1.3], P=0.86), or right ventricular ejection fraction (-0.23% [-1.2 to 0.8], P=0.65). However, both LV and right ventricular volumes were significantly smaller in DM, (LV end-diastolic volume/m2: -3.46 mL/m2 [-5.8 to -1.2], P=0.003, right ventricular end-diastolic volume/m2: -4.2 mL/m2 [-6.8 to -1.7], P=0.001, LV stroke volume/m2: -3.0 mL/m2 [-4.5 to -1.5], P<0.001; right ventricular stroke volume/m2: -3.8 mL/m2 [-6.5 to -1.1], P=0.005), LV mass/volume: 0.026 (0.01 to 0.04) g/mL, P=0.006. Both left atrial and right atrial emptying fraction were lower in DM (right atrial emptying fraction: -6.2% [-10.2 to -2.1], P=0.003; left atrial emptying fraction:-3.5% [-6.9 to -0.1], P=0.043). LV global circumferential strain was impaired in DM (coefficient [95% CI]: 0.38% [0.01 to 0.7], P=0.045). CONCLUSIONS: In a low-risk general population without known cardiovascular disease and with preserved LV ejection fraction, DM is associated with early changes in all 4 cardiac chambers. These findings suggest that diabetic cardiomyopathy is not a regional condition of the LV but affects the heart globally.

KW - cardiomyopathies

KW - cardiovascular

KW - diabetes mellitus

KW - heart disease

KW - magnetic resonance imaging

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U2 - 10.1161/CIRCIMAGING.119.009476

DO - 10.1161/CIRCIMAGING.119.009476

M3 - Article

C2 - 31522551

AN - SCOPUS:85072196079

SN - 1941-9651

VL - 12

SP - e009476

JO - Circulation. Cardiovascular imaging

JF - Circulation. Cardiovascular imaging

IS - 9

ER -

Changes in Cardiac Morphology and Function in Individuals With Diabetes Mellitus: The UK Biobank Cardiovascular Magnetic Resonance Substudy

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Keywords

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