Ratio of transmitral early filling velocity to diastolic strain rate and prognosis in type-1 diabetes
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Ratio of transmitral early filling velocity to diastolic strain rate and prognosis in type-1 diabetes. / Lassen, Mats Christian Højbjerg; Biering-Sørensen, Tor; Jørgensen, Peter Godsk; Bahrami, Hashmat S.Z.; Andersen, Henrik Ullits; Rossing, Peter; Jensen, Magnus T.
In: International Journal of Cardiology, Vol. 397, 131653, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Ratio of transmitral early filling velocity to diastolic strain rate and prognosis in type-1 diabetes
AU - Lassen, Mats Christian Højbjerg
AU - Biering-Sørensen, Tor
AU - Jørgensen, Peter Godsk
AU - Bahrami, Hashmat S.Z.
AU - Andersen, Henrik Ullits
AU - Rossing, Peter
AU - Jensen, Magnus T.
N1 - Publisher Copyright: © 2023 The Author(s)
PY - 2024
Y1 - 2024
N2 - Background: Impaired diastolic function is a hallmark of diabetic cardiomyopathy and a common feature in type 1 diabetes mellitus (T1DM). The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has in recent studies proved to have strong prognostic value. This study aimed to investigate the prognostic value of E/e'sr compared to E/e’ in T1DM without known heart disease. Methods: In this prospective cohort of T1DM patients, echocardiography was performed including two-dimensional speckle tracking. Follow-up was performed using nationwide registries. Outcomes were all-cause mortality and major cardiovascular events (MACE). Results: In total 1079 patients (age: 49.6 ± 14.5 years, 52.5% male, duration of diabetes 25.8 ± 14.6 years) were included in the study. During follow-up (median 6.3 years, IQR:5.7–6.9) 13.2% experienced MACE and 5.8% died. Following multivariable adjustment, both E/e'sr and E/e’ was significantly associated with both MACE (E/e'sr: HR 1.16 CI95%:[1.05–1.29], p = 0.005, per 10 cm increase) vs. (E/e’: HR 1.09 CI95%:[1.03–1.15], p = 0.001, per 1 unit increase) and all-cause mortality (E/e'sr: HR 1.20 [1.03–1.40], p = 0.016) vs. (E/e’: HR: 1.11 [1.02–1.20], p = 0.016). Sex modified the association between E/e'sr and MACE (p for interaction = 0.008) such that E/e'sr after multivariable adjustment only remained significantly associated with MACE in females (HR: 1.41 [1.19–1.67], p < 0.001) but not in males (HR: 1.06 [0.93–1.20], p = 0.42). In females, E/e'sr provided incremental information beyond the Steno T1 Risk Engine (Harrell's C-statistic: 0.78 (0.72–0.83) vs. 0.81 (0.75–0.86), p = 0.007). Conclusion: In patients with T1DM, both E/e'sr and E/e’ provides independent prognostic information regarding prognosis. E/e'sr seems to have stronger prognostic value in females with T1DM.
AB - Background: Impaired diastolic function is a hallmark of diabetic cardiomyopathy and a common feature in type 1 diabetes mellitus (T1DM). The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has in recent studies proved to have strong prognostic value. This study aimed to investigate the prognostic value of E/e'sr compared to E/e’ in T1DM without known heart disease. Methods: In this prospective cohort of T1DM patients, echocardiography was performed including two-dimensional speckle tracking. Follow-up was performed using nationwide registries. Outcomes were all-cause mortality and major cardiovascular events (MACE). Results: In total 1079 patients (age: 49.6 ± 14.5 years, 52.5% male, duration of diabetes 25.8 ± 14.6 years) were included in the study. During follow-up (median 6.3 years, IQR:5.7–6.9) 13.2% experienced MACE and 5.8% died. Following multivariable adjustment, both E/e'sr and E/e’ was significantly associated with both MACE (E/e'sr: HR 1.16 CI95%:[1.05–1.29], p = 0.005, per 10 cm increase) vs. (E/e’: HR 1.09 CI95%:[1.03–1.15], p = 0.001, per 1 unit increase) and all-cause mortality (E/e'sr: HR 1.20 [1.03–1.40], p = 0.016) vs. (E/e’: HR: 1.11 [1.02–1.20], p = 0.016). Sex modified the association between E/e'sr and MACE (p for interaction = 0.008) such that E/e'sr after multivariable adjustment only remained significantly associated with MACE in females (HR: 1.41 [1.19–1.67], p < 0.001) but not in males (HR: 1.06 [0.93–1.20], p = 0.42). In females, E/e'sr provided incremental information beyond the Steno T1 Risk Engine (Harrell's C-statistic: 0.78 (0.72–0.83) vs. 0.81 (0.75–0.86), p = 0.007). Conclusion: In patients with T1DM, both E/e'sr and E/e’ provides independent prognostic information regarding prognosis. E/e'sr seems to have stronger prognostic value in females with T1DM.
KW - Diastolic strain rate
KW - E/e'sr
KW - E/SRe
KW - Type 1 diabetes
U2 - 10.1016/j.ijcard.2023.131653
DO - 10.1016/j.ijcard.2023.131653
M3 - Journal article
C2 - 38101702
AN - SCOPUS:85181038343
VL - 397
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
M1 - 131653
ER -
ID: 381023207