Impact of diabetes mellitus in non-ischemic dilated cardiomyopathy: focus on diastolic dysfunction

Abstract Introduction In patients with diabetes mellitus (DM), the presence of myocardial dysfunction in absence coronary artery disease, valvular disease and other conventional cardiovascular risk factors has been defined as diabetic cardiomyopathy. Left ventricle concentric hypertrophy fibrosis are structural hallmarks that lead to overt diastolic dysfunction. The impact DM imaging features clinical outcomes non-ischaemic dilated cardiomyopathy (DCM) not completely elucidated yet. Purpose We aim describe advance characteristics DCM's DM, its potential on cardiac morphology function comparison non-diabetic patients. Methods From 2014 2021, all DCM were prospectively evaluated our tertiary care hospital. All underwent a transthoracic echocardiogram 165 1.5 Tesla scanner magnetic resonance (CMR) part diagnostic workup. ejection fraction (LVEF), mechanical dyssynchrony, analyzed according current guidelines. Late gadolinium enhancement (LGE) was assessed visually extent calculated number affected segments. Heart failure (HF) hospitalizations, arrhythmic events mortality during follow-up. Results median age cohort (n=227) 61.6 (14.7) years, 66% male, present 57 (25.1%). Mean follow-up 37.6 (33.9) months. Diabetic significantly older, more frequently comorbidity. bundle branch block frequent DM. use SGLT2 inhibitors higher (47.4% vs 21.1%; p<0.05). No significant differences observed regarding guideline-recommended HF drugs. With regard features, no found LVEF global longitudinal strain between two groups. There trend toward left mass index measured by CMR (p=0.364). Parameters dyssynchrony worse (Table 1). High-risk LGE pattern (defined epicardial, transmural or septal plus free-wall LGE) group (p<0.05). Finally, had incidence hospitalization (45.61% 22%, p<0.001) all-cause (24.6% 11.8%, p<0.05), shown Figure 1. also (12.3% 6.5%, p=0.164) this group. Conclusion confers high-risk profile patients, explained extracardiac (more comorbidities) pattern) reasons. These may benefit from close monitoring, new therapies should be developed improve their prognosis. Funding Acknowledgement Type funding sources: None.