Type 2 diabetes impacted left ventricular and atrial function in patients with hypertrophic cardiomyopathy, emphasizing the need for diabetes surveillance.
According to a study published in Cardiovascular Diabetology, diabetes exacerbates left ventricular (LV) and left atrial (LA) functions in patients with HCM, which may impose significant health burdens and adversely impact clinical outcomes. The study authors emphasized the importance of implementing effective diabetes prevention and management measures in this patient population.
Shi-Qin Yu and colleagues investigated the fundamental mechanisms of structural and functional remodeling in patients with HCM and coexisting diabetes (HCM-DM).
“We supposed that diabetes-related adverse cardiac alterations may worsen the clinical manifestations of HCM, but few studies have focused on the effects of type 2 diabetes mellitus on cardiac remodeling in patients with HCM thus far,” the authors wrote. “Therefore, the present study aimed to determine the impact of T2DM on LV and LA function in patients with HCM using cardiac magnetic resonance (CMR) feature tracking.”
The researchers retrospectively included 45 patients with HCM-DM and matched them with HCM controls without diabetes based on maximal wall thickness, age, and gender. The authors used CMR feature tracking strain analyses to evaluate LV and LA performance. Univariable and multivariable linear regression analyses revealed the correlations between diabetes and LV/LA impairment.
The results showed that patients with HCM-DM had smaller end-diastolic and stroke volumes, lower ejection fraction, larger mass/volume ratio, and impaired strains in all directions than isolated HCM controls. Regarding LA parameters, patients with HCM-DM also demonstrated diminished LA reservoir and conduit strain(εe)/strain rate.
For all patients with HCM, comorbidity with diabetes was independently linked to lower LV ejection fraction and impaired global longitudinal strain. Additionally, patients with HCM-DM had more myocardial fibrosis conferring to late gadolinium enhancement, which was an independent predictor of impaired LV global radial strain, LV global circumferential strain, LA reservoir strain(εs), and strain rate.
The authors noted that their findings provide valuable insight regarding how type 2 diabetes adversely affects HCM prognosis.
“In summary, the present study demonstrated the association between adverse LV/LA remodeling and type 2 diabetes mellitus in patients with HCM. The results support the active prevention and close surveillance of type 2 diabetes throughout life as an integral part of the management of HCM,” the authors wrote.
“A prospective study might be warranted to confirm the clinical value of CMR for monitoring the adverse impact of type 2 diabetes on patients with HCM and guiding early therapy to prevent AEs.”
