Evidence mapPaperPMID 41535772Full record

ArticleBMC cardiovascular disorders2026

Suboptimal lipid management is associated with subclinical left ventricular dysfunction in type 2 diabetes mellitus patients with preserved ejection fraction: a cardiac magnetic resonance feature-tracking study.

Zhi-Ming Li, Xue-Chun Guan, Xuan Li, Ying-Yue Chen, Feng-Qiu Ruan, Li-Ling Long

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Article in BMC cardiovascular disorders, 2026. 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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6 authors.

Zhi-Ming LiDepartment of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuang-yong Road, Nanning, Guangxi, 530021, China.
Xue-Chun GuanDepartment of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuang-yong Road, Nanning, Guangxi, 530021, China.
Xuan LiDepartment of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuang-yong Road, Nanning, Guangxi, 530021, China.
Ying-Yue ChenDepartment of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuang-yong Road, Nanning, Guangxi, 530021, China.
Feng-Qiu RuanDepartment of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuang-yong Road, Nanning, Guangxi, 530021, China.
Li-Ling LongDepartment of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuang-yong Road, Nanning, Guangxi, 530021, China. cjr.longliling@vip.163.com.

Funding

Innovation Project of Guangxi Graduate Education YCBZ2025116
6 · The paper itself

Abstract

backgroundDespite guideline recommendations for stringent lipid-lowering targets, achievement rates in high cardiovascular risk patients with type 2 diabetes mellitus (T2DM) remain suboptimal, contributing to residual cardiovascular risk. This study aimed to investigate the relationship between achieving low-density lipoprotein cholesterol (LDL-C) target and subclinical cardiac function in patients with T2DM, utilising cardiac magnetic resonance feature tracking (CMR-FT).

methodsThis study recruited 118 patients with T2DM from January 2019 to December 2024. Differences in left ventricular function characteristics were compared between patients who achieved the LDL-C target and those who did not. Multivariable linear regression and logistic regression analyses were employed to investigate the association between lipid management and subclinical left ventricular dysfunction. The robustness of the analysis was verified through sensitivity analyses, including treating LDL-C as a continuous variable and excluding specific subpopulations.

resultsOf the 118 patients included in the study, 46 (38.9%) met the LDL-C target (LDL-C target achieved group), while 72 (61.1%) did not (LDL-C target nonachieved group). The nonachieved group demonstrated significant signs of adverse cardiac remodelling and impaired myocardial deformation (GLPS: -15.4% ± 3.1% vs. -17.3% ± 3.3%; RI: 0.84 [0.68, 1.08] vs. 0.77 [0.64, 0.88]; P < 0.05). After multivariable adjustment, the LDL-C target nonachieved was independently associated with GLPS impairment (β = -1.53, P = 0.009) and a 4.0-fold increased risk of GLPS abnormality (OR = 4.0, P = 0.006). Sensitivity analyses confirmed the robustness of the findings. When treating LDL-C as a continuous variable, it remained significantly inversely associated with GLPS (β = -0.61, P = 0.040). After excluding patients on PCSK9 inhibitors and those with extreme diabetes duration, failure to achieve the LDL-C target remained significantly associated with reduced GLPS (β = -1.71, P = 0.009) and an increased risk of abnormal GLPS (OR = 3.62, P = 0.021).

conclusionIn high cardiovascular risk patients with T2DM, suboptimal lipid management is associated with subclinical myocardial dysfunction. These results underscore the clinical importance of rigorous lipid control and highlight the potential role of CMR-FT in the early identification of patients who may benefit from intensified management.

Indexed as

Cholesterol, LDLDiabetes Mellitus, Type 2DyslipidemiasMagnetic Resonance Imaging, CineStroke VolumeVentricular Dysfunction, LeftVentricular Function, LeftAgedAsymptomatic DiseasesBiomarkersFemaleGlobal Longitudinal StrainHumansMaleMiddle AgedPredictive Value of TestsBiomarkersCholesterol, LDLCardiac magnetic resonance feature trackingGlobal longitudinal peak strainLow-density lipoprotein cholesterolType 2 diabetes mellitus

Identifiers

PMID41535772
PMCPMC12888148

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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.