Impact of diabetes on remodelling, microvascular function and exercise capacity in aortic stenosis
Rattachement africain : gb, rs, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Objective To characterise cardiac remodelling, exercise capacity and fibroinflammatory biomarkers in patients with aortic stenosis (AS) with and without diabetes, and assess the impact of diabetes on outcomes. Methods Patients with moderate or severe AS with and without diabetes underwent echocardiography, stress cardiovascular magnetic resonance (CMR), cardiopulmonary exercise testing and plasma biomarker analysis. Primary endpoint for survival analysis was a composite of cardiovascular mortality, myocardial infarction, hospitalisation with heart failure, syncope or arrhythmia. Secondary endpoint was all-cause death. Results Diabetes (n=56) and non-diabetes groups (n=198) were well matched for age, sex, ethnicity, blood pressure and severity of AS. The diabetes group had higher body mass index, lower estimated glomerular filtration rate and higher rates of hypertension, hyperlipidaemia and symptoms of AS. Biventricular volumes and systolic function were similar, but the diabetes group had higher extracellular volume fraction (25.9%±3.1% vs 24.8%±2.4%, p=0.020), lower myocardial perfusion reserve (2.02±0.75 vs 2.34±0.68, p=0.046) and lower percentage predicted peak oxygen consumption (68%±21% vs 77%±17%, p=0.002) compared with the non-diabetes group. Higher levels of renin (log 10 renin: 3.27±0.59 vs 2.82±0.69 pg/mL, p<0.001) were found in diabetes. Multivariable Cox regression analysis showed diabetes was not associated with cardiovascular outcomes, but was independently associated with all-cause mortality (HR 2.04, 95% CI 1.05 to 4.00; p=0.037). Conclusions In patients with moderate-to-severe AS, diabetes is associated with reduced exercise capacity, increased diffuse myocardial fibrosis and microvascular dysfunction, but not cardiovascular events despite a small increase in mortality.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of diabetes on remodelling, microvascular function and exercise capacity in aortic stenosis
- Date Crossref
- 01/08/2023
- Éditeur
- BMJ
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Leicester Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre pays non établi dans la noticeUniversité ou école supérieure
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NIHR Leicester Biomedical Research Centre pays non établi dans la noticeStructure de recherche
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Poole Hospital NHS Foundation Trust Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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Centar za Promociju Nauke pays non établi dans la noticeOrganisme public
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Brigham and Women's Hospital Department of Radiology pays non établi dans la noticeÉtablissement de santé
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National Institutes of Health pays non établi dans la noticeOrganisme public
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and Blood Institute Lung pays non établi dans la noticeStructure de recherche
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Bristol-Myers Squibb (United States) pays non établi dans la noticeEntreprise
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Royal Derby Hospital Cardiology Department pays non établi dans la noticeÉtablissement de santé
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Kettering General Hospital Cardiology Department pays non établi dans la noticeÉtablissement de santé
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University of Aberdeen Cardiovascular Medicine Research Unit pays non établi dans la noticeUniversité ou école supérieure
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University of Leeds Department of Biomedical Imaging Sciences pays non établi dans la noticeUniversité ou école supérieure
Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre — University of Leicester, NIHR Leicester Biomedical Research Centre et Department of Cardiology — Poole Hospital NHS Foundation Trust, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.