Principal Investigator: Professor Gerry McCann
Institution: University of LeicesterTags: 43563, arterial stiffness, diabetes, diabetic-cardiomyopathy, Heart failure, Myocardial Strain, physical fitness
The number of people with pre-diabetes and diabetes is rising. One of the major causes of premature death in these people is heart failure. This is when the heart cannot pump blood effectively. It makes people feel tired, breathless and develop swollen limbs and is associated with poor quality of life. It is associated with a high risk of dying.
The prevalence and causes of heart failure in diabetes are uncertain. A key process may be increasing stiffening of the arteries of the body, which may stop the heart from filling and pumping as it should. We will undertake a thorough assessment of heart structure and function and arterial stiffening in people with diabetes and pre-diabetes. To do this we will use the heart MRI data, as well as the blood tests, specialised blood pressure machine data and physical activity monitoring and exercise test readings taken from volunteers in the UK BIOBANK Imaging sub-study. We will compare these data from people with diabetes and pre-diabetes to those without diabetes, as a comparison.
This study will help determine which factors lead to heart failure in people with diabetes, how frequently they occur, and how we might best detect such abnormalities. This will allow us to develop treatments aimed at preventing or treating heart failure in diabetes.
Project extension – April 2020
Current Research questions:
- What is the prevalence of subclinical cardiovascular dysfunction (AHA Stage B) in people with pre-diabetes and diabetes?
- What are the determinants of cardiovascular dysfunction in pre-diabetes and diabetes? How do these differ to those with normoglycaemia?
- To what extent do those with pre-diabetes and diabetes have a higher risk of subclinical cardiovascular dysfunction compared to those without diabetes?
- How does cardiac function relate to objectively measured exercise capacity?
- Compare cardiac systolic strain and diastolic strain rate and peak exercise capacity in healthy adults compared to people with pre-diabetes and diabetes.
- To do this we will need to define normal ranges for cardiac strain in healthy adults to generate a threshold to define subclinical cardiovascular dysfunction.
- Identify determinants of subclinical cardiac dysfunction and reduced exercise capacity in pre-diabetes and diabetes. We will examine the following variables:
- Anthropometric and clinical factors.
- Biochemical factors.
- Left ventricular (LV) geometry.
- Arterial stiffness (by Vicorder and cardiac MRI (CMR) derived measures).
- Diffuse myocardial fibrosis (native T1).
- Physical function.
- Develop a risk score to screen for subclinical cardiovascular dysfunction in pre-diabetes and people with diabetes.
Current scope: The aim of the current study is to determine the prevalence of subclinical systolic and diastolic cardiac dysfunction and identify the key aetiological factors that could be targeted to prevent and treat heart failure in pre-diabetes and diabetes.
Extension of scope: We wish to extend these analysis to include a focus on ethnicity. The additional analysis that we request be applied to the data already received are;
1) Calculate the prevalence of cardiac dysfunction in South Asians compared to White Europeans with overt type 2 diabetes
2) To identify any differences via multivariable regression in cardiac function* between South Asians and White Europeans (matched) with overt Type 2 Diabetes (T2D)
*Left ventricular circumferential peak early diastolic strain rate (PEDSR), longitudinal PEDSR, echocardiographic diastolic function (E/A ratio and E/e’), left ventricular mass and volumes, global systolic strain, rest and stress myocardial perfusion, and left atrial volumes
Last updated Apr 29, 2020