Impact of diabetes and glycemic status on ventricular-arterial coupling in the general population
Holm, Hannes LU ; Zilic, Haris LU ; Jujic, Amra LU ; Johnsson, Linda ; Engström, Gunnar LU ; Nilsson, Peter M LU ; Östgren, Carl Johan LU ; Kylhammar, David LU ; Engvall, Jan and Magnusson, Martin LU
(2025)
In Cardiovascular Diabetology
24(1).
- Abstract
BACKGROUND/AIMS: Ventricular-arterial coupling (VAC) plays a crucial role in cardiovascular physiology, affecting cardiac function and arterial properties for optimal organ perfusion. Considering that diabetes mellitus (DM) is a known risk factor for incident heart disease and vascular damage, this study aims to investigate whether changes in VAC due to DM occur earlier, even before the onset of clinically evident cardiovascular disease in the general population.
METHODS: This retrospective study included 2,884 participants (mean age 57 years, 48% male) of the Swedish CArdioPulmonary BioImage Study (SCAPIS), where data on echocardiography and Pulse wave velocity (PWV) were available. Of these, 162 individuals (6%) had prevalent... (More)
BACKGROUND/AIMS: Ventricular-arterial coupling (VAC) plays a crucial role in cardiovascular physiology, affecting cardiac function and arterial properties for optimal organ perfusion. Considering that diabetes mellitus (DM) is a known risk factor for incident heart disease and vascular damage, this study aims to investigate whether changes in VAC due to DM occur earlier, even before the onset of clinically evident cardiovascular disease in the general population.
METHODS: This retrospective study included 2,884 participants (mean age 57 years, 48% male) of the Swedish CArdioPulmonary BioImage Study (SCAPIS), where data on echocardiography and Pulse wave velocity (PWV) were available. Of these, 162 individuals (6%) had prevalent type 2 diabetes (DM), and 334 (12%) had prediabetes. VAC was quantified as the ratio of PWV to Global longitudinal strain (GLS). Linear regression models were used to assess associations between glycemic status (DM, prediabetes), HbA1c, fasting plasma glucose (fP-glucose), and VAC, adjusting for relevant covariates.
RESULTS: I the fully adjusted model, prevalent DM and the combination of DM and prediabetes were significantly associated with increased values of PWV/GLS (Beta = 0.28, p < 0.001 and Beta = 0.14, p < 0.001 respectively), while no significant association was found between prediabetes and PWV/GLS. Increasing values of HbA1c and fP-glucose were significantly associated with higher values of PWV/GLS (Beta = 0.01,p < 0.001 and Beta = 0.07,p < 0.001, respectively) signaling worse VAC. In participants without prevalent DM, higher HbA1c levels were linked to increased PWV/GLS in the age- and sex-adjusted model; however, this association was attenuated after further adjustment for additional confounders. Conversely, fP-glucose remained significantly associated with elevated PWV/GLS across all adjusted models.
CONCLUSIONS: This study demonstrates a significant association between DM and impaired VAC, as reflected by elevated PWV/GLS, while no such link was observed in prediabetes. The transition from prediabetes to DM appears critical for VAC deterioration. Additionally, higher HbA1c and fP-glucose levels, even in non-diabetic individuals, were associated with worsened VAC, highlighting the impact of glycemic control on vascular function.
(Less)
- author
- Holm, Hannes
LU
; Zilic, Haris
LU
; Jujic, Amra
LU
; Johnsson, Linda
; Engström, Gunnar
LU
; Nilsson, Peter M
LU
; Östgren, Carl Johan
LU
; Kylhammar, David
LU
; Engvall, Jan
and Magnusson, Martin
LU
- organization
- publishing date
- 2025-04-18
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Humans, Male, Middle Aged, Female, Retrospective Studies, Blood Glucose/metabolism, Prediabetic State/epidemiology, Diabetes Mellitus, Type 2/epidemiology, Aged, Glycated Hemoglobin/metabolism, Vascular Stiffness, Biomarkers/blood, Sweden/epidemiology, Ventricular Function, Left, Pulse Wave Analysis, Prevalence, Risk Assessment, Adult, Risk Factors
- in
- Cardiovascular Diabetology
- volume
- 24
- issue
- 1
- article number
- 173
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:40251633
- ISSN
- 1475-2840
- DOI
- 10.1186/s12933-025-02731-7
- language
- English
- LU publication?
- yes
- additional info
- © 2025. The Author(s).
- id
- 9ad30c5f-bbbf-4966-8462-fa2def727dbf
- date added to LUP
- 2025-04-21 10:45:06
- date last changed
- 2025-04-22 08:41:41
@article{9ad30c5f-bbbf-4966-8462-fa2def727dbf,
abstract = {{<p>BACKGROUND/AIMS: Ventricular-arterial coupling (VAC) plays a crucial role in cardiovascular physiology, affecting cardiac function and arterial properties for optimal organ perfusion. Considering that diabetes mellitus (DM) is a known risk factor for incident heart disease and vascular damage, this study aims to investigate whether changes in VAC due to DM occur earlier, even before the onset of clinically evident cardiovascular disease in the general population.</p><p>METHODS: This retrospective study included 2,884 participants (mean age 57 years, 48% male) of the Swedish CArdioPulmonary BioImage Study (SCAPIS), where data on echocardiography and Pulse wave velocity (PWV) were available. Of these, 162 individuals (6%) had prevalent type 2 diabetes (DM), and 334 (12%) had prediabetes. VAC was quantified as the ratio of PWV to Global longitudinal strain (GLS). Linear regression models were used to assess associations between glycemic status (DM, prediabetes), HbA1c, fasting plasma glucose (fP-glucose), and VAC, adjusting for relevant covariates.</p><p>RESULTS: I the fully adjusted model, prevalent DM and the combination of DM and prediabetes were significantly associated with increased values of PWV/GLS (Beta = 0.28, p < 0.001 and Beta = 0.14, p < 0.001 respectively), while no significant association was found between prediabetes and PWV/GLS. Increasing values of HbA1c and fP-glucose were significantly associated with higher values of PWV/GLS (Beta = 0.01,p < 0.001 and Beta = 0.07,p < 0.001, respectively) signaling worse VAC. In participants without prevalent DM, higher HbA1c levels were linked to increased PWV/GLS in the age- and sex-adjusted model; however, this association was attenuated after further adjustment for additional confounders. Conversely, fP-glucose remained significantly associated with elevated PWV/GLS across all adjusted models.</p><p>CONCLUSIONS: This study demonstrates a significant association between DM and impaired VAC, as reflected by elevated PWV/GLS, while no such link was observed in prediabetes. The transition from prediabetes to DM appears critical for VAC deterioration. Additionally, higher HbA1c and fP-glucose levels, even in non-diabetic individuals, were associated with worsened VAC, highlighting the impact of glycemic control on vascular function.</p>}},
author = {{Holm, Hannes and Zilic, Haris and Jujic, Amra and Johnsson, Linda and Engström, Gunnar and Nilsson, Peter M and Östgren, Carl Johan and Kylhammar, David and Engvall, Jan and Magnusson, Martin}},
issn = {{1475-2840}},
keywords = {{Humans; Male; Middle Aged; Female; Retrospective Studies; Blood Glucose/metabolism; Prediabetic State/epidemiology; Diabetes Mellitus, Type 2/epidemiology; Aged; Glycated Hemoglobin/metabolism; Vascular Stiffness; Biomarkers/blood; Sweden/epidemiology; Ventricular Function, Left; Pulse Wave Analysis; Prevalence; Risk Assessment; Adult; Risk Factors}},
language = {{eng}},
month = {{04}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Cardiovascular Diabetology}},
title = {{Impact of diabetes and glycemic status on ventricular-arterial coupling in the general population}},
url = {{http://dx.doi.org/10.1186/s12933-025-02731-7}},
doi = {{10.1186/s12933-025-02731-7}},
volume = {{24}},
year = {{2025}},
}