Elevated hs-CRP in type 2 diabetes patients was significantly associated with higher NYHA class (β=0.76, p=0.029), lower lateral e' (β=-0.32, p=0.004), and higher BMI.
Is elevated hs-CRP associated with impaired cardiac function, structure, and worse symptom burden in patients with type 2 diabetes?
In patients with type 2 diabetes, elevated hs-CRP is associated with diastolic dysfunction and heart failure symptoms, but not with structural myocardial damage or microvascular impairment.
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Abstract Introduction Chronic inflammation, as reflected by high-sensitivity C-reactive protein (hs-CRP), has been linked to poor cardiovascular outcomes. However, the association between hs-CRP and specific cardiac structural, functional, and microvascular abnormalities in type 2 diabetes remains incompletely understood. Cardiac magnetic resonance (CMR) imaging provides a comprehensive assessment. We hypothesized that higher hs-CRP levels would be associated with impaired cardiac function and structure and worse symptom burden in patients with type 2 diabetes. Methods 254 patients with type 2 diabetes who underwent physical examination, New York Heart Association (NYHA) classification. Echo & CMR: cardiac function, native and post-contrast T1 mapping for extracellular volume (ECV), late gadolinium enhancement (LGE). Microvascular function: Adenosine stress perfusion imaging for myocardial blood flow (MBF) and myocardial perfusion reserve (MPR). 3) hs-CRP. Multivariable regression models adjusted for age, sex, DM duration, ischemic heart disease, smoking, autonomic neuropathy, and albuminuria. Results 120 patients had hs-CRP levels below 2 mg/L, 134 had hs-CRP levels above this threshold. Median hs-CRP in the low hs-CRP group was 0.99 mg/L IQR: 0.70, 1.35, in the high hs-CRP group, it was 3.88 mg/L IQR: 2.81, 6.61. No significant differences in age, sex, DM duration, or blood pressure between the 2 groups. Patients with elevated hs-CRP had higher heart rate and a greater proportion of symptomatic individuals, among those with low hs-CRP, 16% were NYHA class II, no patients in class III, in the high hs-CRP group, 20% were NYHA class II, and 6% were NYHA class III. Patients with high hs-CRP had lower left ventricular (LV) mass and end-diastolic volume, which resulted in a lower stroke volume. De No difference in cardiac output due to a compensatory increase in heart rate. In terms of diastolic function, patients with higher hs-CRP levels exhibited a lower lateral e’. No differences cardiac systolic function, MBF, MPR, ECV, or LGE scar burden. Multivariable regression models demonstrated that high hs-CRP was significantly associated with an increased likelihood of being classified as NYHA class II or III compared to class I, even after multivariable adjustment (β = 0.76, p = 0.029). Furthermore, when hs-CRP was treated as a continuous variable (log-transformed), it showed a association with BMI (β = 0.67, p = 0.002) and with lateral e’ (β = -0.32, p = 0.004). However, no associations were found between hs-CRP and MBF, MPR, or ECV. Conclusion Elevated hs-CRP was associated with higher heart rate, lower stroke volume, increased BMI, and diastolic dysfunction and heart failure symptoms. However, hs-CRP was not linked to ECV, LGE or MPR, MBF. These findings suggest that inflammation contributes to heart failure symptoms via diastolic dysfunction rather than structural myocardial damage or microvascular impairment in patients with type 2 diabetes.Tabel 1+2 Fig 1
Bojer et al. (Sat,) reported a other. Elevated hs-CRP in type 2 diabetes patients was significantly associated with higher NYHA class (β=0.76, p=0.029), lower lateral e' (β=-0.32, p=0.004), and higher BMI.