Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study

Background: Heart failure (HF) and diabetes are associated with increased incidence and worse prognosis of each other. The prognostic value of global longitudinal strain (GLS) measured by cardiovascular magnetic resonance (CMR) has not been established in HF patients with diabetes. Methods: In this...

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Main Authors: Iyer, Nithin R., Chan, Siew-Pang, Liew, Oi Wah, Chong, Jenny P. C., Bryant, Jennifer A., Le, Thu-Thao, Chandramouli, Chanchal, Cozzone, Patrick J., Eisenhaber, Frank, Foo, Roger, Richards, A. Mark, Lam, Carolyn S. P., Ugander, Martin, Chin, Calvin W-L.
Other Authors: School of Biological Sciences
Format: Article
Language:English
Published: 2024
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Online Access:https://hdl.handle.net/10356/175590
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Institution: Nanyang Technological University
Language: English
id sg-ntu-dr.10356-175590
record_format dspace
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Medicine, Health and Life Sciences
Magnetic resonance imaging
Heart failure
spellingShingle Medicine, Health and Life Sciences
Magnetic resonance imaging
Heart failure
Iyer, Nithin R.
Chan, Siew-Pang
Liew, Oi Wah
Chong, Jenny P. C.
Bryant, Jennifer A.
Le, Thu-Thao
Chandramouli, Chanchal
Cozzone, Patrick J.
Eisenhaber, Frank
Foo, Roger
Richards, A. Mark
Lam, Carolyn S. P.
Ugander, Martin
Chin, Calvin W-L.
Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study
description Background: Heart failure (HF) and diabetes are associated with increased incidence and worse prognosis of each other. The prognostic value of global longitudinal strain (GLS) measured by cardiovascular magnetic resonance (CMR) has not been established in HF patients with diabetes. Methods: In this prospective, observational study, consecutive patients (n = 315) with HF underwent CMR at 3T, including GLS, late gadolinium enhancement (LGE), native T1, and extracellular volume fraction (ECV) mapping. Plasma biomarker concentrations were measured including: N-terminal pro B-type natriuretic peptide(NT-proBNP), high-sensitivity troponin T(hs-TnT), growth differentiation factor 15(GDF-15), soluble ST2(sST2), and galectin 3(Gal-3). The primary outcome was a composite of all-cause mortality or HF hospitalisation. Results: Compared to those without diabetes (n = 156), the diabetes group (n = 159) had a higher LGE prevalence (76 vs. 60%, p < 0.05), higher T1 (1285±42 vs. 1269±42ms, p < 0.001), and higher ECV (30.5±3.5 vs. 28.8±4.1%, p < 0.001). The diabetes group had higher NT-pro-BNP, hs-TnT, GDF-15, sST2, and Gal-3. Diabetes conferred worse prognosis (hazard ratio (HR) 2.33 [95% confidence interval (CI) 1.43–3.79], p < 0.001). In multivariable Cox regression analysis including clinical markers and plasma biomarkers, sST2 alone remained independently associated with the primary outcome (HR per 1 ng/mL 1.04 [95% CI 1.02–1.07], p = 0.001). In multivariable Cox regression models in the diabetes group, both GLS and sST2 remained prognostic (GLS: HR 1.12 [95% CI 1.03–1.21], p = 0.01; sST2: HR per 1 ng/mL 1.03 [95% CI 1.00-1.06], p = 0.02). Conclusions: Compared to HF patients without diabetes, those with diabetes have worse plasma and CMR markers of fibrosis and a more adverse prognosis. GLS by CMR is a powerful and independent prognostic marker in HF patients with diabetes.
author2 School of Biological Sciences
author_facet School of Biological Sciences
Iyer, Nithin R.
Chan, Siew-Pang
Liew, Oi Wah
Chong, Jenny P. C.
Bryant, Jennifer A.
Le, Thu-Thao
Chandramouli, Chanchal
Cozzone, Patrick J.
Eisenhaber, Frank
Foo, Roger
Richards, A. Mark
Lam, Carolyn S. P.
Ugander, Martin
Chin, Calvin W-L.
format Article
author Iyer, Nithin R.
Chan, Siew-Pang
Liew, Oi Wah
Chong, Jenny P. C.
Bryant, Jennifer A.
Le, Thu-Thao
Chandramouli, Chanchal
Cozzone, Patrick J.
Eisenhaber, Frank
Foo, Roger
Richards, A. Mark
Lam, Carolyn S. P.
Ugander, Martin
Chin, Calvin W-L.
author_sort Iyer, Nithin R.
title Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study
title_short Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study
title_full Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study
title_fullStr Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study
title_full_unstemmed Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study
title_sort global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study
publishDate 2024
url https://hdl.handle.net/10356/175590
_version_ 1800916098755854336
spelling sg-ntu-dr.10356-1755902024-05-06T15:32:07Z Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study Iyer, Nithin R. Chan, Siew-Pang Liew, Oi Wah Chong, Jenny P. C. Bryant, Jennifer A. Le, Thu-Thao Chandramouli, Chanchal Cozzone, Patrick J. Eisenhaber, Frank Foo, Roger Richards, A. Mark Lam, Carolyn S. P. Ugander, Martin Chin, Calvin W-L. School of Biological Sciences Bioinformatics Institute, A*STAR Medicine, Health and Life Sciences Magnetic resonance imaging Heart failure Background: Heart failure (HF) and diabetes are associated with increased incidence and worse prognosis of each other. The prognostic value of global longitudinal strain (GLS) measured by cardiovascular magnetic resonance (CMR) has not been established in HF patients with diabetes. Methods: In this prospective, observational study, consecutive patients (n = 315) with HF underwent CMR at 3T, including GLS, late gadolinium enhancement (LGE), native T1, and extracellular volume fraction (ECV) mapping. Plasma biomarker concentrations were measured including: N-terminal pro B-type natriuretic peptide(NT-proBNP), high-sensitivity troponin T(hs-TnT), growth differentiation factor 15(GDF-15), soluble ST2(sST2), and galectin 3(Gal-3). The primary outcome was a composite of all-cause mortality or HF hospitalisation. Results: Compared to those without diabetes (n = 156), the diabetes group (n = 159) had a higher LGE prevalence (76 vs. 60%, p < 0.05), higher T1 (1285±42 vs. 1269±42ms, p < 0.001), and higher ECV (30.5±3.5 vs. 28.8±4.1%, p < 0.001). The diabetes group had higher NT-pro-BNP, hs-TnT, GDF-15, sST2, and Gal-3. Diabetes conferred worse prognosis (hazard ratio (HR) 2.33 [95% confidence interval (CI) 1.43–3.79], p < 0.001). In multivariable Cox regression analysis including clinical markers and plasma biomarkers, sST2 alone remained independently associated with the primary outcome (HR per 1 ng/mL 1.04 [95% CI 1.02–1.07], p = 0.001). In multivariable Cox regression models in the diabetes group, both GLS and sST2 remained prognostic (GLS: HR 1.12 [95% CI 1.03–1.21], p = 0.01; sST2: HR per 1 ng/mL 1.03 [95% CI 1.00-1.06], p = 0.02). Conclusions: Compared to HF patients without diabetes, those with diabetes have worse plasma and CMR markers of fibrosis and a more adverse prognosis. GLS by CMR is a powerful and independent prognostic marker in HF patients with diabetes. Agency for Science, Technology and Research (A*STAR) Published version The ATTRaCT study was supported by research grants from A*STAR Biomedical Research Council ATTRaCT program [SPF2014/003, SPF2014/004, SPF2014/005] (A*STAR, Singapore). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 2024-04-30T01:42:37Z 2024-04-30T01:42:37Z 2024 Journal Article Iyer, N. R., Chan, S., Liew, O. W., Chong, J. P. C., Bryant, J. A., Le, T., Chandramouli, C., Cozzone, P. J., Eisenhaber, F., Foo, R., Richards, A. M., Lam, C. S. P., Ugander, M. & Chin, C. W. (2024). Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study. BMC Cardiovascular Disorders, 24(1), 141-. https://dx.doi.org/10.1186/s12872-024-03810-5 1471-2261 https://hdl.handle.net/10356/175590 10.1186/s12872-024-03810-5 38443793 2-s2.0-85186895680 1 24 141 en SPF2014/003 SPF2014/004 SPF2014/005 BMC Cardiovascular Disorders © The Author(s) 2024. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. application/pdf