Evidence mapPaperPMID 40887596Full record

ArticleCardiovascular diabetology2025

Left ventricular ejection fraction reserve and its association with myocardial perfusion, coronary calcification, and strain in type 2 diabetes without overt cardiovascular disease.

Adam Chebli, Ida K B Rasmussen, Anne-Cathrine Skriver-Møller, Philip Hasbak, Martin B Blond, Victor S Wasehuus, Mats C H Lassen, Morten Lindhardt, Allan Kofoed-Enevoldsen, Urd L Kielgast and 7 more

Abstract read
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Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Adam ChebliSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark. adamchebli11@hotmail.com.
Ida K B RasmussenSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark.
Anne-Cathrine Skriver-MøllerSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark.
Philip HasbakDepartment of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Rigshospitalet, København, Denmark.
Martin B BlondSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark.
Victor S WasehuusSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark.
Mats C H LassenDepartment of Cardiology, Herlev & Gentofte Hospital, Herlev , Denmark.
Morten LindhardtDepartment of Internal Medicine 1, Holbaek Hospital, Holbaek, Denmark.
Allan Kofoed-EnevoldsenDepartment of Medicine, Zealand University Hospital, Nykøbing Falster, Denmark.
Urd L KielgastDepartment of Medicine, Zealand University Hospital, Køge, Denmark.
Emilie H ZobelSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark.
Lene HolmvangDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Tor Biering-SørensenSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark.
Peter RossingSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark.
Rasmus S RipaDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Andreas KjaerDepartment of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Rigshospitalet, København, Denmark.
Tine W HansenSteno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, Herlev, 2730, Denmark.

Funding

Novo Nordisk Foundation NNF19OC0054674
6 · The paper itself

Abstract

backgroundType 2 diabetes (T2D) is a major risk factor for cardiovascular disease (CVD), but the relationships between myocardial function, microvascular function, and atherosclerotic burden remain underexplored in asymptomatic individuals. This study investigates the associations between left ventricular ejection fraction (LVEF)-reserve, myocardial flow reserve (MFR), perfusion defects, coronary artery calcium score (CACS), and global longitudinal strain (GLS) in individuals with T2D but without overt CVD.

methodsCross-sectional analysis of 871 individuals with T2D without overt CVD, recruited between 2020 and 2023. All underwent cardiac 82-Rubidium PET/CT to assess LVEF-reserve, MFR, perfusion defects, and CACS. GLS was measured using echocardiography. Associations were examined using linear regression adjusted for cardiovascular risk factors and cardiometabolic therapies.

resultsMean (SD) age was 64.9 (± 9.0) years, diabetes duration was 13.9 (± 8.4) years, and 262 (30%) were women. Higher MFR was associated with higher LVEF-reserve (β = 1.63, 95% CI: 1.16 to 2.10, p < 0.001). Individuals with CACS > 300 had lower LVEF-reserve than those with CACS ≤ 300 (β = - 1.25, 95% CI: - 1.97 to - 0.53, p < 0.001). Presence of Perfusion defects were associated with lower LVEF-reserve (β = - 1.49, 95% CI: - 2.23 to - 0.75, p < 0.001). LVEF-reserve was not associated with GLS (p = 0.23). Sensitivity analysis excluding 248 participants with perfusion defects confirmed the association between MFR and LVEF-reserve (β = 1.45 (95% CI: 0.92, 1.97), p < 0.001).

conclusionsIn individuals with T2D without overt CVD, lower MFR, presence of perfusion defects, and CACS > 300 were associated with lower LVEF-reserve. Underscoring a potential role of microvascular dysfunction in subclinical systolic impairment.

Indexed as

Coronary Artery DiseaseCoronary CirculationDiabetes Mellitus, Type 2Fractional Flow Reserve, MyocardialMyocardial Perfusion ImagingStroke VolumeVascular CalcificationVentricular Dysfunction, LeftVentricular Function, LeftAgedAsymptomatic DiseasesCross-Sectional StudiesFemaleHumansMaleMiddle AgedMicrocirculationMyocardial flowMyocardial perfusion imagingVasodilator stress

Identifiers

PMID40887596
PMCPMC12400768

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.