Why the study?
Type 2 diabetes is associated with high heart failure risk, and precise cardiac imaging can help early detection of subclinical myocardial dysfunction in Black adults.
Is glycemic status associated with adverse left ventricular remodeling and dysfunction assessed by cardiac MRI in Black adults?
Cohort (n=1,609)
Is glycemic status associated with adverse left ventricular remodeling and dysfunction assessed by cardiac MRI in Black adults?
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Kaze and colleagues show that diabetes and higher HbA1c track with subtle differences in LV structure and deformation among Black adults, while a single FPG measurement does not track as reliably. The finding supports a plausible biology that the myocardium registers cumulative metabolic exposure before conventional systolic function declines.”
“What distinguishes the present study is its population. Black adults bear a disproportionate burden of both diabetes and heart failure yet remain underrepresented in advanced cardiovascular imaging cohorts. The Jackson Heart Study, purpose‐built to examine cardiovascular health in Black adults, offers an unusually well‐characterized setting in which to test these relationships.”
“In this issue of the Journal of the American Heart Association (JAHA), Kaze and colleagues bring cardiac magnetic resonance imaging (CMR) to bear on that question, using data from the Jackson Heart Study. Among 1609 Black adults, 441 with diabetes and 753 with prediabetes, the investigators related glycemic status, glycated hemoglobin (HbA1c), and fasting plasma glucose (FPG) to left ventricular (LV) mass, chamber volumes, ejection fraction, remodeling index, and tagged CMR–derived circumferential strain.”
In Black adults, diabetes and higher HbA1c are associated with adverse subclinical left ventricular remodeling and impaired myocardial strain on cardiac MRI.
Background Type 2 diabetes is associated with a high risk of heart failure. Hence, precise cardiac imaging can help early detection of subclinical myocardial dysfunction. We investigated the associations of glycemic status and markers with left ventricular (LV) remodeling assessed by cardiac magnetic resonance imaging among Black adults. Methods Peak systolic circumferential strain (Eulerian circumferential systolic strain), LV mass, end‐diastolic volume, end‐systolic volume, LV ejection fraction, and LV remodeling index were measured by cardiac magnetic resonance imaging in JHS (Jackson Heart Study) participants between 2008 and 2012. We evaluated the associations of glycemic markers (fasting plasma glucose and hemoglobin A 1C ) and glycemic status (diabetes, prediabetes, and normoglycemia) with cardiac magnetic resonance imaging measures of LV structure and function. Results A total of 1609 Black participants (mean age, 59 years; 63% women; 27.4% with diabetes and 46.8% with prediabetes) were included. Participants with diabetes had higher LV mass (adjusted β, 4.94 [95% CI, 0.51–9.37]), higher LV remodeling index (β, 0.05 [95% CI: 0.01– 0.09]), impaired global circumferential systolic strain (β, 0.44 [95% CI, 0.04–0.84]), and a higher odds of abnormal strain compared with those with normoglycemia (adjusted odds ratio, 1.43 [95% CI, 1.01–2.04]). Each SD increase in hemoglobin A 1C was associated with higher LV mass (β, 2.48 [95% CI, 0.76–4.21]), LV remodeling index (β, 0.02 [95% CI, 0.01–0.04]), and impaired global circumferential systolic strain (β, 0.21 [95% CI, 0.06–0.37]). Conclusions In a large community‐based cohort of Black individuals, diabetes was associated with differences in LV structure and myocardial strain measured by cardiac magnetic resonance imaging.
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Kazé et al. (2026) conducted a cohort in Type 2 diabetes and prediabetes (n=1,609). Diabetes vs. Normoglycemia was evaluated on Abnormal global circumferential systolic strain (OR 1.43, 95% CI 1.01-2.04).
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