Impact of Diabetes on Myocardial Fibrosis in Patients With Hypertension: The REMODEL Study
Authors' conclusion
Adverse cardiac remodeling was observed in patients with HTN/DM.
Study context
- Population
- Asymptomatic patients with hypertension undergoing CMR
- Participants
- 167 vs 438
- Exposure
- Hypertension with diabetes vs hypertension only
- HTN/DMn = 167
- Hypertensionn = 438reference
- Outcome
- Replacement myocardial fibrosis (nonischemic late gadolinium enhancement on CMR)
Methodological detailsage- and sex-matched
- Age- and sex-matched
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
LV mass, SBP, concentricity, strain
- Similar LV mass
- P = 0.344
- Similar SBP
- P = 0.086
- Increased concentricity and worse multidirectional strain with HTN/DM
- P < 0.001
- P<0.001 for comparison of all strain measures
Proteomic signatures of myocardial fibrosis (184 serum proteins)
- Hypertension: NT-proBNP the only protein upregulated with replacement fibrosis and independently associated with extracellular volume
- HTN/DM: GDF-15 independently associated with replacement fibrosis and extracellular volume
- HTN/DM: increased inflammatory response/immune cell trafficking strongly associated with myocardial fibrosis
Original publication
Impact of Diabetes on Myocardial Fibrosis in Patients With Hypertension: The REMODEL Study. Circ Cardiovasc Imaging. Published 11 July 2023. doi:10.
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