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Assessment of New-Onset Heart Failure Prediction in a Diabetic Population Using Left Ventricular Global Strain: a Prospective Cohort Study Based on UK Biobank

Siwei Chen, Cong Chen, Longxuan Zheng,Wenke Cheng,Xiancong Bu,Zhou Liu

Frontiers in Endocrinology(2024)

Third Hosp Nanchang | Zaozhuang Municipal Hosp | Yangzhou Univ | Univ Leipzig

Cited 1|Views12
Abstract
BackgroundImpaired glucose utilization influences myocardial contractile function. However, the prognostic importance of left ventricular global radial strain (LV-GRS), left ventricular global circumferential strain (LV-GCS), and left ventricular global longitudinal strain (LV-GLS) in predicting new-onset heart failure (HF) in a population with diabetes is unclear.MethodsThe study design is prospective cohort from the UK Biobank. Totally 37,899 participants had a complete data of cardiac magnetic resonance (CMR), of which 940 patients with diabetes were included, and all the participants completed follow-up. LV-GRS, LV-GCS, and LV-GLS were measured by completely automated CMR with tissue tagging. Cox proportional hazards regression analysis and C-index was performed to evaluate the association between the strain parameters and the new-onset HF in patients suffering from diabetes.ResultsThe average age of the 940 participants was 57.67 ± 6.97 years, with males comprising 66.4% of the overall population. With an average follow-up period of 166.82 ± 15.26 months, 35 (3.72%) patients reached the endpoint (emergence of new-onset HF). Significant associations were found for the three strain parameters and the new-onset HF (LV-GRS—hazard ratio [HR]: 0.946, 95% CI: 0.916-0.976; LV-GCS—HR: 1.162, 95% CI: 1.086-1.244; LV-GCS—HR: 1.181, 95% CI: 1.082-1.289). LV-GRS, LV-GCS, and LV-GLS were closely related to the related indicators to HF, and showed a high relationship to new-onset HF in individuals with diabetes at 5 and 10 years: LV-GRS: 0.75 (95% CI, 0.41-0.94) and 0.76 (95% CI, 0.44-0.98), respectively; LV-GCS: 0.80 (95% CI, 0.50-0.96) and 0.75 (95% CI, 0.41-0.98), respectively; LV-GLS: 0.72 (95% CI, 0.40-0.93) and 0.76 (95% CI, 0.48-0.97), respectively. In addition, age, sex, body mass index (BMI), and presence of hypertension or coronary artery disease (CAD) made no impacts on the association between the global strain parameters and the incidence of HF.ConclusionLV-GRS, LV-GCS, and LV-GLS is significantly related to new-onset HF in patients with diabetes at 5 and 10 years.
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global radial strain,global circumferential strain,global longitudinal strain,heart failure,UK biobank
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要点】:本研究通过UK Biobank的前瞻性队列研究,发现糖尿病患者中左心室全局径向应变(LV-GRS)、左心室全局环形应变(LV-GCS)和左心室全局纵向应变(LV-GLS)与心衰新发风险显著相关,不受年龄、性别、体重指数及高血压或冠心病影响。

方法】:利用UK Biobank中37,899名参与者的完整心脏磁共振(CMR)数据,对940名糖尿病患者进行跟踪,通过完全自动化的CMR组织标记技术测量LV-GRS、LV-GCS和LV-GLS,并使用Cox比例风险回归分析和C指数评估应变参数与心衰新发风险的关系。

实验】:在平均随访期166.82±15.26个月中,3.72%的糖尿病患者达到终点(新发心衰),三种应变参数与心衰新发风险显著相关,数据集名称为UK Biobank。