Nina Nouhravesh1, Henrik U Andersen2, Jan S Jensen3, Peter Rossing4, Magnus T Jensen5. 1. Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaards vej 28, 2900 Hellerup, Denmark. Electronic address: nina_030890@hotmail.com. 2. Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark. 3. Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaards vej 28, 2900 Hellerup, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark. 4. Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Faculty of Health, University of Aarhus, Katrinebergvej 89F, 8200 Aarhus N, Denmark. 5. Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaards vej 28, 2900 Hellerup, Denmark; Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Department of Internal Medicine, Holbaek Hospital, Smedelundsvej 60, 4300 Holbaek, Denmark.
Abstract
AIMS: Retinopathy and heart disease in Type 1 Diabetes Mellitus (Type 1 DM) may be associated; however previous results have been conflicting. Tissue Doppler Imaging (TDI) and speckle-tracking echocardiography (STE) quantify myocardial function not assessable by conventional echocardiography. We investigated the association between severity of retinopathy and early myocardial dysfunction using conventional echocardiography, TDI and STE in Type 1 DM patients. METHODS: Type 1 Diabetes Mellitus patients without known heart disease were included from the Steno Diabetes Center. The cross sectional association between retinopathy and myocardial function was analyzed in uni-and multivariable models. Retinopathy was categorized as nil-, simplex- or proliferative retinopathy. RESULTS: A total of 1090 Type 1 Diabetes Mellitus patients were included, mean age was 49.6years and 53% were males. Left ventricular ejection fraction did not differ between groups of retinopathy. Global longitudinal strain (GLS) by STE decreased significantly with increasing degrees of retinopathy (nil; -18.6%, simplex; -18.2% (p=0.024), proliferative; -17.7% (p<0.001)), however differences attenuated in multivariable models (p⩾0.05). In univariable models, myocardial tissue velocities differed in relation to retinopathy: s' (nil; 6.9, simplex; 6.5, proliferative; 5.9 (p=0.001), e' (nil; 10.4, simplex; 9.2, proliferative; 7.9, p<0.001), a' (nil; 6.1, simplex; 6.7, proliferative; 7.0, p<0.001) and E/e' (nil; 6.7, simplex; 7.5, proliferative; 9.5, p<0.001). In multivariable models, differences persisted between nil and proliferative retinopathy for s', e' and E/e'. CONCLUSION: Proliferative retinopathy is independently associated with decreased myocardial function assessed by Tissue Doppler Imaging in patients with Type 1 Diabetes Mellitus without history of heart disease.
AIMS: Retinopathy and heart disease in Type 1 Diabetes Mellitus (Type 1 DM) may be associated; however previous results have been conflicting. Tissue Doppler Imaging (TDI) and speckle-tracking echocardiography (STE) quantify myocardial function not assessable by conventional echocardiography. We investigated the association between severity of retinopathy and early myocardial dysfunction using conventional echocardiography, TDI and STE in Type 1 DMpatients. METHODS:Type 1 Diabetes Mellituspatients without known heart disease were included from the Steno Diabetes Center. The cross sectional association between retinopathy and myocardial function was analyzed in uni-and multivariable models. Retinopathy was categorized as nil-, simplex- or proliferative retinopathy. RESULTS: A total of 1090 Type 1 Diabetes Mellituspatients were included, mean age was 49.6years and 53% were males. Left ventricular ejection fraction did not differ between groups of retinopathy. Global longitudinal strain (GLS) by STE decreased significantly with increasing degrees of retinopathy (nil; -18.6%, simplex; -18.2% (p=0.024), proliferative; -17.7% (p<0.001)), however differences attenuated in multivariable models (p⩾0.05). In univariable models, myocardial tissue velocities differed in relation to retinopathy: s' (nil; 6.9, simplex; 6.5, proliferative; 5.9 (p=0.001), e' (nil; 10.4, simplex; 9.2, proliferative; 7.9, p<0.001), a' (nil; 6.1, simplex; 6.7, proliferative; 7.0, p<0.001) and E/e' (nil; 6.7, simplex; 7.5, proliferative; 9.5, p<0.001). In multivariable models, differences persisted between nil and proliferative retinopathy for s', e' and E/e'. CONCLUSION:Proliferative retinopathy is independently associated with decreased myocardial function assessed by Tissue Doppler Imaging in patients with Type 1 Diabetes Mellitus without history of heart disease.
Authors: Magnus T Jensen; Peter Sogaard; Ida Gustafsson; Jan Bech; Thomas F Hansen; Thomas Almdal; Simone Theilade; Tor Biering-Sørensen; Peter G Jørgensen; Søren Galatius; Henrik U Andersen; Peter Rossing Journal: Diabetologia Date: 2019-10-30 Impact factor: 10.122