Multi-modal characterisation of cardiac function and electrophysiology in type 2 diabetes: a UK Biobank cross-sectional study

Abstract

AbstractBackground and AimType 2 diabetes mellitus (T2DM) is a major risk factor for heart failure, ischemic heart disease, and cardiac arrhythmias. Our goal is to examine the association of T2DM with ECG and cardiac imaging biomarkers, providing a window into the adverse effects of T2DM on cardiac health.MethodsUsing data from the UK Biobank, we investigated ECG and cardiac magnetic resonance imaging biomarkers in a cohort of 1781 participants with T2DM and no diagnosed cardiovascular disease at time of assessment. We performed a pair-matched cross-sectional study to examine the association between type 2 diabetes and multi-modal cardiac biomarkers. We built multivariate multiple linear regression models sequentially adjusted for socio-demographic, lifestyle, and clinical covariates.ResultsT2DM was associated with a higher resting heart rate (66 vs 61 beats per minute, p<0.001), longer QTc interval (424 vs 420 ms, p<0.001), reduced T-wave amplitude (0.33 vs 0.37 mV, p<0.001), lower stroke volume (72 vs 78 ml, p<0.001) and thicker left ventricular wall (6.1 vs 5.9 mm, p<0.001). These trends were consistent in subgroups of different sex, age and body mass index. Fewer significant differences were noted in non-white participants. QRS duration and Sokolow-Lyon index were associated with the development of cardiovascular disease in groups with and without T2DM, respectively. A higher left ventricular mass and wall thickness were associated with cardiovascular outcomes in both groups.ConclusionT2DM was associated with adverse changes in ECG and cardiac imaging biomarkers, possibly reflecting subclinical cardiac repolarisation abnormalities, autonomic dysfunction, hypertrophy and impaired mechanical function.