Simone Theilade1, Peter Rossing2, Jesper Eugen-Olsen3, Jan S Jensen4, Magnus T Jensen5. 1. Steno Diabetes CenterGentofte, Denmark ktld@steno.dk. 2. Steno Diabetes CenterGentofte, Denmark Aarhus UniversityAarhus, Denmark University of CopenhagenCopenhagen, Denmark. 3. Clinical Research CenterHvidovre Hospital, Hvidovre, Denmark. 4. University of CopenhagenCopenhagen, Denmark Department of CardiologyGentofte Hospital, Gentofte, Denmark. 5. Steno Diabetes CenterGentofte, Denmark Department of CardiologyGentofte Hospital, Gentofte, Denmark Department of Internal MedicineHolbaek Sygehus, Holbaek, Denmark.
Abstract
AIM: Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods. METHODS: In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates. RESULTS: Patients were 55±12 years (mean±s.d.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58±5%. suPAR levels were not associated with LVEF (P=0.11). In adjusted models, higher suPAR levels were independently associated with both impaired systolic function assessed with global longitudinal strain (GLS) and tissue velocity s', and with impaired diastolic measures a' and e'/a' (all P=0.034). In multivariable analysis including cardiovascular risk factors and both systolic and diastolic measures (GLS and e'/a'), both remained independently associated with suPAR levels (P=0.012). CONCLUSIONS: In patients with type 1 diabetes with normal LVEF and without known heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy.
AIM: Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods. METHODS: In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates. RESULTS:Patients were 55±12 years (mean±s.d.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58±5%. suPAR levels were not associated with LVEF (P=0.11). In adjusted models, higher suPAR levels were independently associated with both impaired systolic function assessed with global longitudinal strain (GLS) and tissue velocity s', and with impaired diastolic measures a' and e'/a' (all P=0.034). In multivariable analysis including cardiovascular risk factors and both systolic and diastolic measures (GLS and e'/a'), both remained independently associated with suPAR levels (P=0.012). CONCLUSIONS: In patients with type 1 diabetes with normal LVEF and without known heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy.
Authors: Christian S Hansen; Tommi Suvitaival; Simone Theilade; Ismo Mattila; Maria Lajer; Kajetan Trošt; Linda Ahonen; Tine W Hansen; Cristina Legido-Quigley; Peter Rossing; Tarunveer S Ahluwalia Journal: Front Endocrinol (Lausanne) Date: 2022-04-14 Impact factor: 6.055
Authors: Angela S Koh; Bhaarathy Velmurugan; Fei Gao; Ru San Tan; Jia-Ing Wong; Louis L Y Teo; Bryan M H Keng; Serene J M Chua; Jian-Min Yuan; Woon-Puay Koh; Christine Cheung Journal: BMC Geriatr Date: 2017-11-28 Impact factor: 3.921
Authors: Dimitrios Velissaris; Nicholas Zareifopoulos; Ioanna Koniari; Vasilios Karamouzos; Dimitris Bousis; Andreas Gerakaris; Christina Platanaki; Nicholas Kounis Journal: J Clin Med Res Date: 2021-03-19
Authors: Theis Bjerre-Christensen; Signe A Winther; Nete Tofte; Simone Theilade; Tarunveer S Ahluwalia; Maria Lajer; Tine W Hansen; Peter Rossing; Christian Stevns Hansen Journal: BMJ Open Diabetes Res Care Date: 2021-10