Left ventricular ejection fraction reserve and its association with myocardial perfusion, coronary calcification, and strain in type 2 diabetes without overt cardiovascular disease
Main finding · LVEF-reserveResult — go to the resultβ - 1.25 95% CI - 1.97 to - 0.53Authors' conclusion
In individuals with T2D without overt CVD, lower MFR, presence of perfusion defects, and CACS > 300 were associated with lower LVEF-reserve. Underscoring a potential role of microvascular dysfunction in subclinical systolic impairment.
Study context
- Population
- Individuals with T2D without overt cardiovascular disease (CVD), recruited 2020–2023; mean age 64.9 years, diabetes duration 13.9 years, 30% women
- Participants
- 871 individuals
- Exposure
- Coronary artery calcium score (CACS) > 300 vs CACS ≤ 300
- Outcome
- Associations of LVEF-reserve with MFR, perfusion defects, CACS and GLS (82-Rubidium PET/CT; echocardiography for GLS)
Main finding
LVEF-reserve
β
- 1.25
95% CI - 1.97 to - 0.53
P < 0.001
As reported in the abstract
- Higher myocardial flow reserve (MFR) associated with higher left ventricular ejection fraction (LVEF)-reserve: β (95% CI 1.16 to 2.10), p < 0.001
- 1.63
- Perfusion defects associated with lower LVEF-reserve: β (95% CI - 2.23 to - 0.75), p < 0.001
- - 1.49
Observational data: associations, not effects.
Further findings
Sensitivity analysis excluding 248 participants with perfusion defects: MFR and LVEF-reserve
- MFR associated with LVEF-reserve: β (95% CI 0.92, 1.97), p < 0.001
- 1.45
Original publication
Left ventricular ejection fraction reserve and its association with myocardial perfusion, coronary calcification, and strain in type 2 diabetes without overt cardiovascular disease. Cardiovasc Diabetol. Published 31 August 2025. doi:10.
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