In 202 T2D patients, lower GFR correlated with higher interventricular septal thickness (r=-0.224) and elevated E/e’ (r=-0.243), indicating early cardiac remodeling.
Is lower glomerular filtration rate associated with left heart remodeling in patients with type 2 diabetes?
In patients with type 2 diabetes, lower glomerular filtration rate is independently associated with early subclinical cardiac remodeling, particularly elevated E/e' and atrial stiffness index.
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Abstract Background Type 2 Diabetes (T2D) is associated with renal function decline, however, its impact on cardiac remodeling remains unclear. Speckle-tracking echocardiography has emerged as a powerful tool for detecting subclinical cardiac dysfunction, offering novel insights into early structural and functional changes. Purpose This study aimed to evaluate the relationship between glomerular filtration rate (GFR) and left heart remodeling, assessed via echocardiographic parameters in T2D patients, with a particular focus on speckle-tracking-derived parameters, including left atrial reservoir strain (LASr) and the novel atrial stiffness index (E/e’/LASr). Methods A cross-sectional study was conducted in individuals with T2D. Spearman correlation coefficients assessed the relationship between GFR and echocardiographic parameters of heart structure, remodeling and function. Linear regression models examined the association between GFR and E/e’, adjusting for relevant confounders. Results A total of 202 individuals were included. A decline in GFR was significantly associated with increased interventricular septal thickness (r = -0.224, p = 0.001), elevated E/e’ (r = -0.243, p 0.001), and higher atrial stiffness index (r = -0.212, p = 0.002). Regression analysis confirmed that lower GFR was independently associated with higher E/e’ values, even after adjusting for confounders (β = -0.032, p 0.001). However, no significant associations were observed between GFR and conventional left ventricular function parameters. Conclusion Our findings suggest that impaired renal function in T2D patients is linked to early cardiac remodeling, particularly through elevated E/e’, a marker of left ventricular diastolic dysfunction. While traditional measures of ventricular function were not significantly associated with GFR, the novel atrial stiffness index may serve as a novel stratification tool for detecting subclinical cardiac remodeling in this high-risk population.
Gomez-Aviles et al. (Sat,) reported a other. In 202 T2D patients, lower GFR correlated with higher interventricular septal thickness (r=-0.224) and elevated E/e’ (r=-0.243), indicating early cardiac remodeling.