Diabetes and Myocardial Fibrosis: A Systematic Review and Meta-Analysis.

Salvador, Dante B. Jr.; Gamba, Magda R; Gonzalez Jaramillo, Nathalia; Gonzalez-Jaramillo, Valentina; Raguindin, Peter Francis N; Minder, Beatrice; Gräni, Christoph; Wilhelm, Matthias; Stettler, Christoph; Doria, Alessandro; Franco, Oscar H; Muka, Taulant; Bano, Arjola (2022). Diabetes and Myocardial Fibrosis: A Systematic Review and Meta-Analysis. JACC. Cardiovascular imaging, 15(5), pp. 796-808. Elsevier 10.1016/j.jcmg.2021.12.008

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Objectives

This systematic review and meta-analysis investigated the association of diabetes and glycemic control with myocardial fibrosis (MF).
Background

MF is associated with an increased risk of heart failure, coronary artery disease, arrhythmias, and death. Diabetes may influence the development of MF, but evidence is inconsistent.
Methods

We searched EMBASE, Medline Ovid, Cochrane CENTRAL, Web of Science, and Google Scholar for observational and interventional studies investigating the association of diabetes, glycemic control, and antidiabetic medication with MF assessed by histology and cardiac magnetic resonance (ie, extracellular volume fraction [ECV%] and T1 time).
Results

A total of 32 studies (88% exclusively on type 2 diabetes) involving 5,053 participants were included in the systematic review. Meta-analyses showed that diabetes was associated with a higher degree of MF assessed by histological collagen volume fraction (n = 6 studies; mean difference: 5.80; 95% CI: 2.00-9.59) and ECV% (n = 13 studies; mean difference: 2.09; 95% CI: 0.92-3.27), but not by native or postcontrast T1 time. Higher glycosylated hemoglobin levels were associated with higher degrees of MF.
Conclusions

Diabetes is associated with higher degree of MF assessed by histology and ECV% but not by T1 time. In patients with diabetes, worse glycemic control was associated with higher MF degrees. These findings mostly apply to type 2 diabetes and warrant further investigation into whether these associations are causal and which medications could attenuate MF in patients with diabetes.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Pavillon 52 > Endokrinologie / Diabetologie (Erwachsene)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
13 Central Units > Administrative Director's Office > University Library of Bern

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Salvador, Dante Jr.; Gamba Rincón, Magda Rocío; Gonzalez Jaramillo, Nathalia; Gonzalez Jaramillo, Valentina; Raguindin, Peter Francis; Minder, Beatrice; Gräni, Christoph; Wilhelm, Matthias; Stettler, Christoph; Franco Duran, Oscar Horacio; Muka, Taulant and Bano, Arjola

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
000 Computer science, knowledge & systems > 020 Library & information sciences

ISSN:

1936-878X

Publisher:

Elsevier

Funders:

[164] Marie Skłodowska-Curie Actions (European Commission)

Language:

English

Submitter:

Dante Jr. Salvador

Date Deposited:

09 Mar 2022 11:30

Last Modified:

14 Jun 2022 19:56

Publisher DOI:

10.1016/j.jcmg.2021.12.008

PubMed ID:

35512952

Uncontrolled Keywords:

CMR T1 mapping, diabetes, glycosylated hemoglobin, meta-analysis, myocardial extracellular matrix, myocardial fibrosis

BORIS DOI:

10.48350/166412

URI:

https://boris.unibe.ch/id/eprint/166412

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