Evrim Bengi Turkbey MD, Presenter: Nothing to Disclose

Aditya Jain MBBS, MPH, Abstract Co-Author: Nothing to Disclose

Jye-Yu C. Backlund, Abstract Co-Author: Nothing to Disclose

Patricia A. Cleary, Abstract Co-Author: Nothing to Disclose

Joao A. C. Lima MD, Abstract Co-Author: Grant, Toshiba Corporation Grant, Bracco Group Grant, Astellas Group Grant, Deltanoid Pharmaceuticals, Inc

Cuilian Miao MD, MD, Abstract Co-Author: Nothing to Disclose

Chia-Ying Liu, Abstract Co-Author: Nothing to Disclose

David Nathan, Abstract Co-Author: Nothing to Disclose

John M. Lachin, Abstract Co-Author: Nothing to Disclose

Saul Genuth, Abstract Co-Author: Nothing to Disclose

David A. Bluemke MD, PhD, Abstract Co-Author: Nothing to Disclose

To determine the relationship of cardiovascular disease (CVD) risk factors, including HbA1c levels and diabetic nephropathy, to left ventricular (LV) structure and function in type 1 diabetes mellitus (T1DM).

1017 subjects of the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) T1DM cohort(mean age 49 years; 48 % female, mean duration of diabetes: 28 years) had cardiac MRI (CMR) for evaluation of LV structure and function. Of these, 741 (73%) also had gadolinium delayed enhancement CMR. Associations of CVD risk factors, including mean HbA1c and macroalbuminuria (albumin excretion rate > 300 mg/24hr or end stage renal disease), with cardiac outcomes were assessed using multivariate regression models after adjusting for machine type, height, and weight.

Mean HbA1c levels measured over an average of 22 yrs were inversely associated with end-diastolic volume (EDV, -2.9 ml per 1% mean HbA1c) and stroke volume (-2.2 ml per 1% mean HbA1c) and positively related to elevated LV mass/EDV ratio (0.02 g/ml per 1% mean HbA1c). Patients who smoked had significantly higher LV mass than those who did not smoke (by 7.5 g). Patients with macroalbuminuria had significantly higher LV mass (by 14.8 g) and LV mass/EDV ratio (by 8%) compared to those without macroalbuminuria. LV mass was increased by 8 g per 10 mm Hg mean systolic blood pressure (Table 1). 4.3% of patients had myocardial scar. Greater LV mass and end diastolic volume were significantly associated with presence of myocardial scar (i.e. odds ratio 1.04, 95% confidence interval [1.01-1.07] per one g/m2 LV mass index, p=0.022).

In a large cohort of T1DM, elevated HbA1c levels, traditional CVD risk factors, and nephropathy were associated with significant alterations in LV structure and function, including greater LV mass relative to LV volume. These findings may have important implications with respect to cardiomyopathy in T1DM.

The features of diabetic cardiomyopathy have been studied extensively in type 2 diabetes. There is much less documentation of the determinants of myocardial structure and function in type 1 diabetes.

Turkbey, E, Jain, A, Backlund, J, Cleary, P, Lima, J, Miao, C, Liu, C, Nathan, D, Lachin, J, Genuth, S, Bluemke, D, Relationship of Cardiovascular Risk Factors to Left Ventricular Structure and Function in Type 1 Diabetes Mellitus: Results from the Diabetes Control and Complications Trial/ Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007781.html