Presence of micro- and macroalbuminuria and the association with cardiac mechanics in patients with type 2 diabetes
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Presence of micro- and macroalbuminuria and the association with cardiac mechanics in patients with type 2 diabetes. / Jørgensen, Peter Godsk; Biering-Sørensen, Tor; Mogelvang, Rasmus; Fritz-Hansen, Thomas; Vilsbøll, Tina; Rossing, Peter; Jensen, Jan Skov.
I: European Heart Journal Cardiovascular Imaging, Bind 19, Nr. 9, 2018, s. 1034-1041.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Presence of micro- and macroalbuminuria and the association with cardiac mechanics in patients with type 2 diabetes
AU - Jørgensen, Peter Godsk
AU - Biering-Sørensen, Tor
AU - Mogelvang, Rasmus
AU - Fritz-Hansen, Thomas
AU - Vilsbøll, Tina
AU - Rossing, Peter
AU - Jensen, Jan Skov
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.
PY - 2018
Y1 - 2018
N2 - Aims: Albuminuria-a marker of generalized vascular dysfunction-is a strong predictor of heart failure in patients with type 2 diabetes which may be caused by concomitant myocardial dysfunction reflecting the same underlying pathogenesis.Methods and results: We included 915 patients with type 2 diabetes from two secondary care centres and stratified according to albuminuria status in normo-, micro-, and macroalbuminuria. We performed comprehensive echocardiography including conventional imaging, tissue Doppler imaging, and 2D speckle tracking. Cardiac remodelling occurred in patients with increasing left ventricular (LV) mass index and LV wall thicknesses with increasing severity of albuminuria. Diastolic measures worsened across groups of albuminuria severity (normo-, micro-, and macroalbuminuria, respectively): septal e' velocity [mean: 6.9 cm/s (SD 1.9), 6.4 (1.7), and 5.9 (1.7), P < 0.001], septal E/e' (median: 10.6 [interquartile range: 8.9-13.2], 12.1 [10.3-14.8], and 12.7 [10.4-16.6], P < 0.001), and left atrial volume index (24.3 mL/m2 [19.1-29.9], 25.7 [20.0-31.6], and 29.0 [22.2-34.9], P < 0.001) In contrast, systolic measures were only impaired in patients with macroalbuminuria: global longitudinal strain (GLS): [-14.6% (2.7) in normo- and -13.3 (2.9) in macroalbuminuria, P < 0.001] and GLS rate [mean: -0.79 s-1 (0.17) in normo- and -0.72 (0.16) in macroalbuminuria, P = 0.001]. The findings persisted in subgroup analyses of patients without known coronary heart disease and with normal ejection fraction and in multivariable adjusted analyses.Conclusion: In patients with type 2 diabetes, microalbuminuria is associated with decreased diastolic function whereas decreased systolic function was only associated with macroalbuminuria supporting the notion of similar pathogenic mechanisms of albuminuria and impaired myocardial function.
AB - Aims: Albuminuria-a marker of generalized vascular dysfunction-is a strong predictor of heart failure in patients with type 2 diabetes which may be caused by concomitant myocardial dysfunction reflecting the same underlying pathogenesis.Methods and results: We included 915 patients with type 2 diabetes from two secondary care centres and stratified according to albuminuria status in normo-, micro-, and macroalbuminuria. We performed comprehensive echocardiography including conventional imaging, tissue Doppler imaging, and 2D speckle tracking. Cardiac remodelling occurred in patients with increasing left ventricular (LV) mass index and LV wall thicknesses with increasing severity of albuminuria. Diastolic measures worsened across groups of albuminuria severity (normo-, micro-, and macroalbuminuria, respectively): septal e' velocity [mean: 6.9 cm/s (SD 1.9), 6.4 (1.7), and 5.9 (1.7), P < 0.001], septal E/e' (median: 10.6 [interquartile range: 8.9-13.2], 12.1 [10.3-14.8], and 12.7 [10.4-16.6], P < 0.001), and left atrial volume index (24.3 mL/m2 [19.1-29.9], 25.7 [20.0-31.6], and 29.0 [22.2-34.9], P < 0.001) In contrast, systolic measures were only impaired in patients with macroalbuminuria: global longitudinal strain (GLS): [-14.6% (2.7) in normo- and -13.3 (2.9) in macroalbuminuria, P < 0.001] and GLS rate [mean: -0.79 s-1 (0.17) in normo- and -0.72 (0.16) in macroalbuminuria, P = 0.001]. The findings persisted in subgroup analyses of patients without known coronary heart disease and with normal ejection fraction and in multivariable adjusted analyses.Conclusion: In patients with type 2 diabetes, microalbuminuria is associated with decreased diastolic function whereas decreased systolic function was only associated with macroalbuminuria supporting the notion of similar pathogenic mechanisms of albuminuria and impaired myocardial function.
U2 - 10.1093/ehjci/jex231
DO - 10.1093/ehjci/jex231
M3 - Journal article
C2 - 29029007
VL - 19
SP - 1034
EP - 1041
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 9
ER -
ID: 195040030