Systemic proinflammatory−profibrotic response in aortic stenosis patients with diabetes and its relationship with myocardial remodeling and clinical outcome
Main finding · Composite of HF hospitalization and death (imaging cohort)Result — go to the resultHazard ratio 1.88 95% CI 1.06–3.31Authors' conclusion
Plasma proteomic analyses indicate that diabetes potentiates the systemic proinflammatory-profibrotic milieu in AS patients. These systemic biological changes underlie the increase of myocardial fibrosis, diastolic dysfunction, and worse clinical outcomes in severe AS patients with concomitant diabetes.
Study context
- Population
- Patients with severe aortic stenosis (AS)imaging 253
- Exposure
- Diabetic vs nondiabetic severe AS patients
- Outcome
- Composite of:
- Hospitalization for HF
- Death (imaging cohort)
- Follow-up
- Median 6.3 years
Methodological detailstwo prospective cohorts, imaging cohort (echocardiography and cardiac MRI), biomarker cohort (plasma proteomics, 92 biomarkers)
- Two prospective cohorts
- Imaging cohort (echocardiography and cardiac MRI)
- Biomarker cohort (plasma proteomics, 92 biomarkers)
Main finding
As reported in the abstract
Composite of:
- HF hospitalization
- Death (imaging cohort)
Hazard ratio
1.88
95% CI 1.06–3.31
P = 0.030
Diabeticvs nondiabetic severe AS patients
HR 1.88 (95% CI 1.06–3.31); P = 0.030
- HF admissions or death during follow-up, imaging cohort
- 53
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Myocardial fibrosis (imaging cohort)Diabetic vs Nondiabetic | P = 0.009 |
| Myocardial fibrosis (imaging cohort)Diabetic vs Nondiabetic | P = 0.025 |
- Myocardial fibrosis (imaging cohort): late gadolinium enhancement % 0.3 [0.0-1.6] vs 0.0 [0.0-0.5]; higher with diabetes
- Myocardial fibrosis (imaging cohort): extracellular volume fraction % 27.9 [25.7-30.1] vs 26.7 [24.9-28.5]; higher with diabetes
Myocardial fibrosis (imaging cohort)
- Diabetic patients were older (70.4 ± 6.8 vs 66.7 ± 10.1 years) with more advanced ventricular diastolic dysfunction
Plasma proteomics (biomarker cohort)
- Proteins significantly elevated in diabetic AS patients (E-selectin, IL-1 receptor types 1 and 2, galectin-4, ICAM-2, integrin beta-2, galectin-3, GDF-15, cathepsin D)
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- Inflammatory response and extracellular matrix pathways enriched in diabetic AS patients
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Systemic proinflammatory−profibrotic response in aortic stenosis patients with diabetes and its relationship with myocardial remodeling and clinical outcome. Cardiovasc Diabetol. Published 10 February 2023. doi:10.
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