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Congestive cardiomyopathy

Type 2 Diabetes Increases Risk of Poor Outcomes in Patients with Non-Ischemic Dilated Cardiomyopathy

Strategic Insights

— 2 min read

Research has shown that patients with type 2 diabetes mellitus (T2DM) have poorer long-term outcomes when diagnosed with non-ischemic dilated cardiomyopathy (DCM). A study conducted by researchers from the Huazhong University of Science and Technology in Wuhan, People's Republic of China, aimed to investigate the prognostic significance of T2DM on late gadolinium enhancement (LGE) patterns and bi-ventricular myocardial strain in non-ischemic DCM patients. The study analyzed 423 non-ischemic DCM patients, 121 with T2DM and 302 without, who underwent cardiovascular magnetic resonance (CMR).

Key Takeaways:

  • Patients with T2DM had significantly lower left ventricular (LV) global longitudinal strain (GLS) compared to those without T2DM, with a mean value of -6.2% (interquartile range, -7.8% to -4.8%).
  • The study found that combining NT-proBNP, HbA1c, LVGLS, and ischemic LGE prevalence may serve as effective markers for predicting outcomes in T2DM patients.
  • The research suggests that patients with T2DM have a higher risk of major adverse cardiac events (MACE) during follow-up, including cardiovascular death, heart transplantation, heart-failure readmission, and LV assist device implantation for advanced heart failure.
  • The study's findings highlight the importance of screening for T2DM in patients with non-ischemic DCM, as early detection and management of T2DM may improve patient outcomes.
  • The researchers used Cox regression analysis and Kaplan-Meier analysis to assess the associations between variables and outcomes, providing a comprehensive understanding of the relationship between T2DM, LGE patterns, and bi-ventricular strain in non-ischemic DCM patients.

Statistics:

  • 423 non-ischemic DCM patients were included in the study, with 121 patients having T2DM and 302 without.
  • The mean LVGLS value for patients with T2DM was -6.2% (IQR, -7.8% to -4.8%).
  • The study found that patients with T2DM had a higher risk of major adverse cardiac events (MACE) during follow-up, with a hazard ratio of 2.35 (95% CI, 1.44-3.81).
  • The researchers reported that combining NT-proBNP, HbA1c, LVGLS, and ischemic LGE prevalence may serve as effective markers for predicting outcomes in T2DM patients, with a sensitivity of 92.3% and specificity of 86.2%.

Sources:

  • Prognostic implications of biventricular strain and ischemic-pattern fibrosis in non-ischemic dilated cardiomyopathy with type 2 diabetes mellitus: a cardiac MRI cohort study. Quantitative Imaging in Medicine and Surgery, 2025;15(10):9945-9962.
  • Huazhong University of Science and Technology, Dept. of Radiology, Union Hospital, Tongji Medical College, Wuhan, People's Republic of China.
  • Ame Publishing Company, Flat-Rm C 16F, Kings Wing Plaza 1, No 3 Kwan St, Shatin, Hong Kong 00000, Peoples R China.

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