Introduction: Type 2 diabetes is a major risk factor for heart failure. Large-scale prospective studies are an ideal resource to characterise high-risk populations and identify early markers of disease.
Aim: Our goal is to quantify cardiac function in individuals with type 2 diabetes and no prior cardiovascular disease, in order to identify signs of early-stage cardiac remodelling.
Methods: Using multiple ascertainment pathways, we define a cohort of subjects with type 2 diabetes in the UK Biobank study, and extract these subjects' ECG and cardiac magnetic resonance image-derived biomarkers related to diastolic function and cardiac autonomic neuropathy.
Results: We identified 1781 subjects with type 2 diabetes using a combination of ICD codes, self-report, and circulating haemoglobin A1c levels. The cohort was mostly male, overweight, and elderly. We found that males and females with type 2 diabetes exhibit a QTc interval in the upper boundary of normal clinical ranges, with 272 subjects (15%) meeting age- and sex- specific clinical criteria for QTc prolongation, while 668 subjects (38%) had a ventricular rate above 70 bpm. These markers may indicate cardiac auto- nomic neuropathy and a higher risk of adverse cardiovascular complications. Left ventricular mass, end-diastolic volume, ejection fraction and maximum wall thickness were found to be within normal ranges, suggesting an absence of perceptible structural remodelling in these subjects.
Conclusion: The presence of subclinical electrophysiological abnormalities found in individuals with type 2 diabetes supports the need for adequate, sex-specific monitoring of early-stage adverse cardiac remodelling in the diabetic population.