Abstract 12030: Myocardial Extracellular Volume in Patients With Type 2 Diabetes

Introduction: Myocardial interstitial fibrosis expands the extracellular volume (ECV) and is in patients with type 2 diabetes implicated in the development of heart failure. ECV can be determined with gadolinium-contrast magnetic resonance imaging. Hypothesis: We investigated if known risk factors for cardiovascular disease were associated with increased ECV in patients with type 2 diabetes. Methods: 296 patients with type 2 diabetes and 21 healthy sex and age-matched controls were included in a cross-sectional magnetic resonance imaging study. The influence of risk factors on ECV was investigated by multiple regression analysis. Results: Controls and patients with type 2 diabetes without complications had similar ECV (27.1±2.1% vs. 27.9±2.6%, p=0.2). Compared to patients without, ECV was significantly increased in patients with 1≥ complication (29.0±3.3%, p=0.02). Both in univariable analysis and after multivariable adjustment, ischemic heart disease, autonomic neuropathy and active smoking were associated with increased levels of ECV. Active smoking exhibited the largest effect size (ß=2.0%-point 95%CI 0.7 to 3.3). Former smokers had similar ECV than never smokers. Albuminuria and systolic blood pressure were inversely associated with ECV in multivariable analysis but after adjustment for medication suspected to affect ECV the association to albuminuria was no longer significant (p=0.1). There was a trend toward SGLT2i treatment being associated with reduced ECV (-0.8% 95%CI -1.7 to 0.06, p=0.067). Conclusions: Patients with complications to diabetes have increased ECV not seen in patients without. Active but not former smoking was highly associated with increased ECV but also Ischemic heart disease, and autonomic neuropathy.