Abstract 14941: Association of WATCH-DM Risk Score With Cardiac Abnormalities and Prevalence of Diabetic Cardiomyopathy: A Prospective Cohort Study

Abstract

Introduction: Diabetic cardiomyopathy (DbCM) is characterized by abnormal cardiac structure or function in the absence of cardiovascular disease (CVD). We assessed whether WATCH-DM, a validated risk score to predict incident heart failure (HF) in patients with DM, can identify DbCM. Methods: We prospectively enrolled 150 individuals with DM free of known CVD or overt HF in a single-center institution. The presence of DbCM was calculated using different definitions: 1) least restrictive: ≥1 echocardiographic abnormality (left atrial enlargement, left ventricular hypertrophy, diastolic dysfunction); 2) intermediate restrictive: ≥2 echocardiographic abnormalities; and 3) most restrictive: elevated N-terminal pro-B-type natriuretic peptide levels (>125 in normal/overweight or >100 pg/mL in obese) plus ≥2 echocardiographic abnormalities. DbCM prevalence was compared across high (scores ≥ 11) and low (scores < 11) WATCH-DM using chi-squared test. Adjusted logistic regression models were used to evaluate the association between WATCH-DM and components of DbCM. Results: The prevalence of DbCM ranged from 60.7% to 7.3% in the least and most restrictive definitions, respectively. Subjects with high (vs. low) WATCH-DM score were more often males (58% vs 32%), older (71 vs 68 years) and had a longer duration of DM (13 vs 10 years). Moreover, the concentration of NT pro-BNP was observed to be significantly higher in the high WATCH-DM cohort. Across definitions, individuals with high WATCH-DM had a numerically higher prevalence of DbCM ( Fig. A ). Among individual components, high WATCH-DM was associated with a higher risk of diastolic dysfunction (OR [95% CI] = 2.53 [1.20-5.54]) ( Fig. B ). We observed no significant differences in LV hypertrophy or LA enlargement across WATCH-DM scores. Conclusion: High WATCH-DM risk score is associated with a higher prevalence of DbCM and echocardiographic abnormalities and may be an effective tool for identifying patients with DbCM.