Autoimmune mechanism proposed for some cardiac dysfunction in type 1 diabetes
medwireNews: Researchers show that the presence of multiple cardiac autoantibodies is associated with subclinical myocardial dysfunction in people with type 1 diabetes.
People with two or more cardiac autoantibodies had a dilated remodeling cardiac phenotype, report Myra Lipes (Harvard Medical School, Boston, Massachusetts, USA) and study co-authors in Circulation.
Despite no history of cardiovascular disease, they had significantly increased end-diastolic and end-systolic volume, increased left ventricular mass, and reduced ejection fraction compared with those without autoantibodies, after adjustment for vascular risk factors.
The study focused on 892 participants of the EDIC study, with an average age of 49 years and type 1 diabetes duration of 28 years. Those with two autoantibodies comprised 5% of the cohort, while 11% had one autoantibody. Having autoantibodies was associated with receipt of conventional treatment during the DCCT, higher glucose levels over time, and more microvascular complications, says the team, “suggesting that cardiac autoantibodies are markers of long-term glycemic exposure.”
In contrast to the results for autoantibodies, the researchers found glycated hemoglobin level to be associated only with “minimally decreased” end-diastolic volume, “calling into question the extent to which [type 1 diabetes] affects the myocardium.”
They believe their findings suggest “a potentially novel pathophysiological process associated with cardiac autoimmunity in [type 1 diabetes],” but note the need for longer follow-up to determine the risk for progression to heart failure.
medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group