Poor Glycemic Control Is Associated With Increased Extracellular Volume Fraction in Diabetes

• DOI: 10.2337/dc18-0324
• Publication Date: 2018-07-12T15:25:52Z
• Authors: Ahmed Al-Badri; Zeba Hashmath; Garrett H. Oldland; Rachana Miller; Khuzaima Javaid; Amer Ahmed Syed; Bilal Ansari; Swetha Gaddam; Walter R. Witschey; Scott R. Akers; Julio A. Chirinos
• Keywords: Myocardial fibrosis; Glycated hemoglobin

OBJECTIVE We assessed whether poor glycemic control is associated with an increase in myocardial fibrosis among adults diabetes. RESEARCH DESIGN AND METHODS studied 47 type 2 diabetes and stratified them into three groups according to their hemoglobin A1c (HbA1c) level: <6.5% (group 1; n = 12), 6.5–7.5% 2; 20), >7.5% 3; 15). Left ventricular (LV) mass was using cardiac MRI. The extracellular volume fraction (ECVF), index of fibrosis, measured by T1 mapping before after the administration a gadolinium-based contrast agent. RESULTS Mean HbA1c 5.84 ± 0.16%, 6.89 0.14%, 8.57 0.2% 1, 2, 3, respectively. LV not significantly different between groups. ECVF greater (mean 27.6% [95% CI 24.8–30.3]) 3 (27.6% [24.4–30.8]) than group 1 (21.1% [17.5–24.7]; P 0.015). After adjusting for age, sex, BMI, blood pressure, estimated glomerular filtration rate, (27.4% [24.4–30.4]) (28% [24.5–31.5]) (20.9% [17.1–24.6]; 0.0156, ANCOVA). CONCLUSIONS An increased ECVF, suggesting independently Further research should assess tight can revert healthy myocardium or ameliorate it its adverse clinical consequences.