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Kidney Week

Abstract: PO0976

Changes in Cardiac Microvascular Function in Persons with Type 2 Diabetes in Relation to Kidney Function

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Rasmussen, Ida, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Hasbak, Philip, Rigshospitalet, Kobenhavn, Denmark
  • Von Scholten, Bernt Johan, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Laursen, Jens christian, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Hein Zobel, Emilie, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Holmvang, Lene, Rigshospitalet, Kobenhavn, Denmark
  • Ripa, Rasmus S., Rigshospitalet, Kobenhavn, Denmark
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Kjaer, Andreas, Rigshospitalet, Kobenhavn, Denmark
  • Hansen, Tine, Steno Diabetes Center Copenhagen, Gentofte, Denmark
Background

The myocardial flow reserve (MFR) reflects the function of both large epicardial arteries and the microcirculation. Coronary artery calcium score (CACS) is a measure of coronary atherosclerosis. Cardiac 82Rb PET/CT provides a measurement of both MFR and CACS. Knowledge on changes in MFR and CACS over time and the impact of kidney function on these changes is lacking

Methods

In 2013 we recruited 60 persons with type 2 diabetes (T2D) and 30 non-diabetic controls (C); all free of overt cardiovascular disease. All underwent a cardiac 82Rb PET/CT scan. In 2019, survivors (n=82) were invited for a repeated cardiac 82Rb PET/CT after a similar protocol. 29 with T2D and 19 C participated.

Results

Median [interquartile range] duration between visits was 6.2 [6.0–6.3] years. The Table summarizes kidney function, MFR and CACS at the 2 visits. MFR was lower in persons with T2D compared to C but change in MFR was similar between groups (p=0.62) and did not differ between visits within the groups (C:p=0.51, T2D:p=0.08). CACS was higher in persons with T2D compared to C at both visits. CACS increased between visits within both groups (C:p=0.015, T2D:p<0.001), and the change was higher in T2D (p=0.002).
In the total cohort, lower eGFR at baseline was associated with higher decline in MFR (p=0.027), but not after adjustment (p=0.70). Increase in CACS was higher in men (p=0.03), but not after adjustment (p=0.07). Changes in MFR and CACS were not associated with other risk factors at baseline.

Conclusion

MFR was lower in T2D compared to C but did not change significantly in either of the groups when evaluated over 6 years. Kidney function had no independent impact on changes in MFR or CACS

 Type 2 diabetes
(n=29)
Controls
(n=19)
P
(unadjusted)
P
(adjusted)
UAER visit 1 (mg/24-h)27.3 [6.5, 145]5.5 [5.0, 6.5]<0.001 
eGFR visit 1
(ml/min/1.73m2)
81.1 (21.5)87.6 (11.1)0.23 
MFR visit 12.6 (0.7)3.3 (0.7)0.0010.83
MFR visit 22.4 (0.6)3.2 (0.9)<0.0010.46
MFR difference-0.27 [-0.48, 0.06]-0.20 [-0.65, 0.50]0.620.32
CACS visit 1180 [22, 275]0 [0, 54]<0.0010.03
CACS visit 2560 [136, 981]18 [0, 116]<0.0010.04
CACS difference301 [72, 830]9 [0, 62]0.0020.12

Adjustment included; age, sex, BMI, eGFR, urinary albumin excretion rate, 24-h systolic BP, heart rate, total cholesterol and smoking