ArticleCardiovascular diabetology2023
Systemic proinflammatory-profibrotic response in aortic stenosis patients with diabetes and its relationship with myocardial remodeling and clinical outcome.
Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 23 citations in OpenAlex.
- Type 2 diabetes is associated with clinical progression of aortic stenosis: a nationwide retrospective study in Sweden.Scientific reports · 2026Article
- Shared pathophysiological mechanisms between diabetes and calcific aortic valve disease: an immunometabolic perspective.Cardiovascular diabetology · 2026Review
- Association of Elevated Galectin-4 Concentrations with Obesity, Diabetes, and Cardiovascular Diseases.International journal of molecular sciences · 2025Review
- Diabetes mellitus aggravates myocardial inflammation and oxidative stress in aortic stenosis: a mechanistic link to HFpEF features.Cardiovascular diabetology · 2025Article
- Impact of glycemic control metrics on short- and long-term mortality in transcatheter aortic valve replacement patients: a retrospective cohort study from the MIMIC-IV database.Cardiovascular diabetology · 2025Article
- Diabetes and calcific aortic valve disease: controversy of clinical outcomes in diabetes after aortic valve replacement.Frontiers in endocrinology · 2025Review
- Evaluation of Plasma E-Selectin Concentration as a Risk Marker for Atherosclerotic Vascular Damage in Patients with Early CAD.Biomolecules · 2024Article
- AI-Enhanced Prediction of Aortic Stenosis Progression: Insights From the PROGRESSA Study.JACC. Advances · 2024Article
- Understanding Galectin-3's Role in Diastolic Dysfunction: A Contemporary Perspective.Life (Basel, Switzerland) · 2024Review
- Prognostic effect of stress hyperglycemia ratio on patients with severe aortic stenosis receiving transcatheter aortic valve replacement: a prospective cohort study.Cardiovascular diabetology · 2024Article
- Galectin-4 is associated with diabetes and obesity in a heart failure population.Scientific reports · 2023Observational
- Calcineurin/NFATc3 pathway mediates myocardial fibrosis in diabetes by impairing enhancer of zeste homolog 2 of cardiac fibroblasts.BMC cardiovascular disorders · 2023Article
- Impact of diabetes on remodelling, microvascular function and exercise capacity in aortic stenosis.Open heart · 2023Article
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8 authors at 5 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies have mainly focused more on how diabetes affects the valve than the myocardium in aortic stenosis (AS). In the pressure-overloaded heart, myocardial fibrosis is an important driver of the progression from compensated hypertrophy to heart failure. Using comprehensive noninvasive imaging and plasma proteomics, we investigated whether and how diabetes aggravates the remodeling of the myocardium and its relation with prognosis in AS patients.
methodsSevere AS patients were enrolled in two prospective cohorts for imaging and biomarker analysis. The imaging cohort (n = 253) underwent echocardiography and cardiac magnetic resonance, and the biomarker cohort (n = 100) blood sampling with multiplex proximity extension assay for 92 proteomic biomarkers. The composite outcome of hospitalization for heart failure admissions and death was assessed in the imaging cohort.
resultsDiabetic patients were older (70.4 ± 6.8 versus 66.7 ± 10.1 years) with more advanced ventricular diastolic dysfunction and increased replacement and diffuse interstitial fibrosis (late gadolinium enhancement % 0.3 [0.0-1.6] versus 0.0 [0.0-0.5], p = 0.009; extracellular volume fraction % 27.9 [25.7-30.1] versus 26.7 [24.9-28.5], p = 0.025) in the imaging cohort. Plasma proteomics analysis of the biomarker cohort revealed that 9 proteins (E-selectin, interleukin-1 receptor type 1, interleukin-1 receptor type 2, galectin-4, intercellular adhesion molecule 2, integrin beta-2, galectin-3, growth differentiation factor 15, and cathepsin D) were significantly elevated and that pathways related to inflammatory response and extracellular matrix components were enriched in diabetic AS patients. During follow-up (median 6.3 years), there were 53 unexpected heart failure admissions or death in the imaging cohort. Diabetes was a significant predictor of heart failure and death, independent of clinical covariates and aortic valve replacement (HR 1.88, 95% CI 1.06-3.31, p = 0.030).
conclusionsPlasma proteomic analyses indicate that diabetes potentiates the systemic proinflammatory-profibrotic milieu in AS patients. These systemic biological changes underlie the increase of myocardial fibrosis, diastolic dysfunction, and worse clinical outcomes in severe AS patients with concomitant diabetes.
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