Cardiac Abnormalities In Patients Research Articles

Myocardial Strain Assessment for Early Duchenne Muscular Dystrophy Diagnosis in Pediatric Patients Using Cardiac MRI

Assessing myocardial strain remains challenging, particularly in the pediatric population, due to the smaller heart sizes, higher heart rates, and variability in strain parameters compared to adult populations. This study aimed to investigate the utility of myocardial strain measurements using cardiac magnetic resonance-feature tracking (CMR-FT) for early diagnosis of Duchenne muscular dystrophy (DMD) in pediatric patients. Twenty-eight DMD patients and 20 healthy controls were involved in this study. Global circumferential, longitudinal, and radial strain (GCS, GLS, and GRS) were measured for the left ventricle (LV) using CMR-FT. Segmental strain values only of the inferolateral and anterolateral LV segments in DMD patients without late gadolinium enhancement (LGE) and DMD patients with LGE were compared to the healthy controls. Strain measurements using CMR-FT in DMD patients were considerably lower than those of healthy controls, with all p-values lower than 0.001. DMD patients without LGE showed decreased inferolateral and anterolateral segmental values only relative to healthy controls. The same behavior was maintained for the LV geometry. Multivariable linear regression demonstrated that the end-systole (ES) wall thicknesses and thickening were associated with decreased GCS and GLS. CMR-FT is crucial in detecting cardiac abnormalities in patients with DMD. It represents an innovative imaging biomarker that can detect initial myocardial alterations in DMD cardiomyopathy without relying on gadolinium.

The impact of high dose corticosteroid treatment affect on cardiac abnormalities in patients with multiple sclerosis

Aims: High-dose corticosteroids to control acute relapses of multiple sclerosis, leveraging their anti-inflammatory effects. However, these treatments can lead to cardiovascular side effects. Understanding the pathophysiology of corticosteroid induced bradycardia is paramount for healthcare providers. Our aim in this study are to identify risk factors for cardiac side effects and assess the timing of cardiac complications relative to treatment. Methods: Patients who met the McDonald's criteria for definite MS and patients requiring admission for pulse steroid treatment with an acute recurrence were included.Individuals taking cardiac medications, or with a heart illness were excluded.Patients were given 1 g IV methylprednisolone in 2 hours for five to seven days in order to treat acute relapses. Results: We studied with 23 patients(6 males and 17 females, 26.1/73.9% respectively).The mean±SD age of the patients was 34.6±9.9 (18-43) years and the mean±SD duration of disease was 5.5±4.9 years.Most of the patients were relapsing–remitting MS in 73.9%, primary progressive in 4.4% and secondary progressive in 21.7%.The most common cardiac arhythmia during corticosteroid pulse therapy was sinus bradycradia(n=6). Conclusion: The combination of direct effects on cardiac myocytes, electrolyte disturbances, autonomic dysfunction, and individual genetic factors can contribute to the development of bradycardia in MS patients treated with high-dose methylprednisolone. Close monitoring and prompt intervention are crucial to manage this adverse effect and optimize patient safety.

Anemia in patients with chronic kidney disease and its association with cardiac abnormalities

Abstract Introduction Chronic kidney disease (CKD) is a pathology characterized by multisystemic comorbidities, predominantly associated with cardiovascular disease and anemia. However, the precise association between the degree of anemia and the development of cardiac abnormalities in patients with CKD undergoing hemodialysis remains unclear. Purpose To determine the association between the degree of anemia and cardiac abnormalities in patients with CKD receiving hemodialysis treatment. Methods A cross-sectional multicenter study that included individuals with CKD undergoing hemodialysis was conducted. Electronic medical records containing information regarding medical conditions and pertinent laboratory parameters was collected, and cardiac function was determined using echocardiography. A Spearman rank correlation analysis was conducted to evaluate the associated between the degree of anemia and echocardiographic parameters, with significant set at p <0.05. Results Ninety-nine individuals were included, with a median age of 48 years. The population was categorized based on hemoglobin (Hb) levels into non/mild anemia (Hb >10 mg/dL) and moderate/severe anemia (Hb <9.9 mg/dL) groups (table). Significant differences were observed in left ventricle (LV) posterior wall thickness (10mm in non/mild vs. 11mm in moderate/severe, p<0.015), left atrial (LA) volume (34 mL/m2 in non/mild vs. 39 mL/m2 in moderate/severe, p<0.007) and left ventricular ejection fraction (LVEF) (59% in non/mild vs. 55% in moderate/severe, p<0.025). Negative correlations (figure) were observed between Hb levels and LV mass index (r= -0.21, p= 0.03) and pulmonary artery systolic pressure (PASP)(r= -0.27, p= 0.006). Conclusion The degree of anemia demonstrated an association with cardiac abnormalities, as evidenced by alterations in echocardiographic parameters such as LVEF, LA volume and PSAP. This study underscores the importance of further prospective investigations to enhance early identification and stratification of anemia in patients with CKD aiming to mitigate further cardiac complications.Clinical demographics tableScatter plots with correlation graphs

The spectrum of cardiac abnormalities in patients with acromegaly: results from a case-control cardiac magnetic resonance study

PurposeCardiac abnormalities are common in patients with acromegaly, contributing to the increased morbidity and mortality. Cardiac magnetic resonance (CMR) is the gold standard for measuring cardiac morpho-functional changes. This study aims to detect cardiac alterations in acromegaly through CMR, even when the disease is adequately controlled.MethodsIn this, multicentre, case-control study, we compared consecutive patients with acromegaly, cured after surgery or requiring medical treatment, with matched controls recruited among patients harbouring non-functioning adrenal incidentalomas.ResultsWe included 20 patients with acromegaly (7 females, mean age 50 years) and 17 controls. Indexed left ventricular-end-diastolic volume (LV-EDVi) and LV-end-systolic volume (LV-ESVi) were higher in patients than in controls (p < 0.001), as were left ventricular mass (LVMi) (p = 0.001) and LV-stroke volume (LV-SVi) (p = 0.028). Right ventricle (RV) EDVi and ESVi were higher, whereas RV-ejection fraction (RV-EF) was lower (p = 0.002) in patients than in controls (p < 0.001). No significant differences were observed in the prevalence of cardiometabolic comorbidities, including hypertension, glucose and lipid metabolism impairment, obstructive sleep apnoea syndrome, and obesity. IGF1 x upper limit of normal significantly predicted LVMi (b = 0.575; p = 0.008). Subgroup analysis showed higher LVMi (p = 0.025) and interventricular septum thickness (p = 0.003) in male than female patients, even after adjusting cardiac parameters for confounding factors.ConclusionsThe CMR analysis reveals a cluster of biventricular structural and functional impairment in acromegaly, even when the biochemical control if achieved. These findings appear specifically triggered by the exposure to GH-IGF1 excess and show sex-related differences advocating a possible interaction with sex hormones in cardiac disease progression.

Cardiac evaluation in amiodarone-induced thyroid dysfunction with suspected cardiac ischemia?: a case report and review of the literature

BackgroundAmiodarone-induced thyroid dysfunction (AIT) is a side-effect associated with the use of Amiodarone for the treatment of refractory arrythmias. Resulting hyperthyroidism can precipitate cardiac complications, including cardiac ischemia and myocardial infarction, although this has only been described in a few case reports.Case presentationWe present here a clinical scenario involving a 66-year-old male Caucasian patient under Amiodarone for atrial fibrillation, who developed AIT. In the presence of dyspnea, multiple cardiovascular risk factors and ECG abnormalities, a transthoracic echocardiogram was performed, showing inferobasal hypokinesia. This led to further investigations through a cardiac PET-CT, where cardiac ischemia was suspected. Ultimately, the coronary angiography revealed no abnormalities. Nonetheless, these extensive cardiologic investigations led to a delay in initiating an emergency endovascular revascularization for acute-on-chronic left limb ischemia. Although initial treatment using Carbimazole was not successful after three weeks, the patient reached euthyroidism after completion of the treatment with Prednisone so that eventually thyroidectomy was not performed. Endovascular revascularization was finally performed after more than one month.ConclusionsWe discuss here cardiac abnormalities in patients with AIT, which may be due to relative ischemia secondary to increased metabolic demand during hyperthyroidism. Improvement of cardiac complications is expected through an optimal AIT therapy including medical therapy as the primary approach and, when necessary, thyroidectomy. Cardiac investigations in the context of AIT should be carefully considered and may not justify delaying other crucial interventions. If considered mandatory, diagnostic procedures such as coronary angiography should be preferred to functional testing.

Cardiac abnormalities pre- and post-liver transplantation for metabolic dysfunction-associated steatohepatitis – Evidence and special considerations

Metabolic dysfunction-associated steatotic liver disease (MASLD) has an alarmingly high global prevalence. Its progressive subtype, metabolic dysfunction-associated steatohepatitis (MASH), is the leading indication for liver transplantation overall. Although MASLD has been associated with increased risk for several cardiac abnormalities including cardiac arrhythmias, structural disease, heart failure, valvular disease, and coronary artery disease, little is known about the clinical course and effects of these abnormalities in post-liver transplant patients with MASH as an etiology of their cirrhosis. This narrative review presents clinical and mechanistic evidence for the association of MASLD with the aforementioned cardiac abnormalities, as well as characterizes what is known about their significance in the post-operative period for those undergoing liver transplantation for MASH. Additionally, this review emphasizes knowledge gaps and highlights areas for further study of the impact of cardiac abnormalities in patients undergoing liver transplantation for MASH.

(1324) - Prevalence and Risk Factors of Cardiac Abnormalities in Patients with End-Stage Renal Disease

(1324) - Prevalence and Risk Factors of Cardiac Abnormalities in Patients with End-Stage Renal Disease

Echocardiography Coupled with Strain Method in the Screening for Cardiac Involvement in Rheumatoid Arthritis.

In this study, the usefulness of transthoracic echocardiography (TTE) in systematic screening was assessed for various cardiac abnormalities in patients with rheumatoid arthritis (RA). We performed a comparative cross-sectional study from July 2020 to February 2021. Each patient underwent a TTE coupled with the strain technique. Seventy-two RA patients and 72 controls were included. Abnormalities detected by TTE were more frequent in RA patients (80.6% vs. 36.1%; p < 0.01), and they were asymptomatic in 65.5% of cases. Valvular involvement was found in 45.8% of RA patients, with a significant difference (p < 0.01). Left ventricular diastolic dysfunction was also more frequent in the RA group (36.1% vs. 13.9%; p < 0.01). Left ventricular systolic dysfunction was absent in our study, but subclinical left ventricular myocardial damage assessed by Global Longitudinal Strain (GLS) method was found in 37.5% of RA patients and 16.6% of controls (p < 0.01). The mean GLS in RA patients was -17.8 ± 2.9 (-22 to -10.7) vs. -19.4 ± 1.9 (-24.7 to -15.7) in controls. Left ventricular hypertrophy was detected in 22.2% of RA patients and in 6.9% of controls (p < 0.01). Pericardial effusion and pulmonary arterial hypertension were present only in the RA group (2.8% of cases). We found a significant relationship between echocardiographic damage and disease activity (p < 0.01), number of painful joints (p < 0.01), functional impact (HAQ) (p = 0.01), CRP level (p < 0.01) and the use and dose of Corticosteroids (p = 0.02; p = 0.01). Echocardiographic damage in RA is frequent and often asymptomatic, hence there has been an increased interest in systematic screening in order to improve the quality of life and vital prognosis of patients. Early management of RA can reduce the risk of occurrence of cardiac involvement.

Abstract 12142: Treadmill Exercise Stress Echocardiography Exposes Impaired Left Ventricular Function in Patients Recovering From Hospitalization for COVID-19 versus Historical Controls

Usual clinical testing rarely reveals persisting cardiac abnormalities in patients after hospitalization for Covid-19. Such testing may overlook residual changes responsible for increased adverse cardiac events seen post-discharge. To further elucidate patients’ long-term status, we performed exercise stress echocardiography (ESE) in 15 patients age 30-63 without myocarditis 3 to 31 months after hospital discharge. We compared patient outcomes to published data in healthy controls (HC) exercising according to the same protocol. Patients’ treadmill exercise (Bruce protocol), averaging 8.2 min, was halted by dyspnea or fatigue. Baselines before stress averaged the same in recovering patients (RP) and HC except for heart rate (HR): 81±13 bpm for RP and 63±8 for HC (p&lt;0.0001). Peak stress values in RP were compared with HC: Stress revealed significantly lower LVEF and raised E/e’ soon after peak effort in RP compared with HC performing the same exercise. Thus, when stressed, patients with no known cardiac impairment before or during Covid-19 hospitalization showed modest but consistently diminished systolic contractile function and diastolic LV compliance during recovery compared to HC. Peak HR during stress was significantly elevated in RP vs. HC; peak SBP also trended higher. Average systolic pulmonary artery pressures among RP remained normal. Our measurements during ESE uniquely identified residual abnormality in cardiac contractile function not evident in the unstressed condition. This finding exposes a previously-unrecognized residual influence of Covid-19 that may relate to underlying autonomic dysfunction, microvascular disease, or diffuse interstitial changes after subclinical myocarditis and may have long-term implications for clinical management and later prognosis.

Cardiac Abnormalities in Patients With Severe Fever With Thrombocytopenia Syndrome: A Systematic Review

Abstract Since the identification of severe fever with thrombocytopenia syndrome virus (SFTSV) in 2010, there has been an increase in reported cases in China and other Asian countries. Cardiac abnormalities are highly prevalent in SFTS patients. We searched 5 Chinese and international databases for published SFTS articles and extracted patient characteristics, cardiac complications, electrocardiography findings, and imaging findings. Twenty-seven studies were identified, covering 1938 patients and 621 cardiac abnormalities. Arrhythmia was the most prevalent, reported in 24 studies and 525 cases, with a prevalence of 27.09%. The 2 major types of arrhythmias were bradycardia and atrial fibrillation. Heart failure was the second most prevalent abnormality, with 77 cases. Changes in the ST segment and T wave were the most common. Valve regurgitation, reduced ejection fraction, and pericardial effusion were also documented. We recommend that physicians pay close attention to newly onset arrhythmia and structural heart disease in SFTS patients.

ICU nurses' knowledge and attitude towards electrocardiogram interpretation in Fujian province, China: a cross-sectional study.

The series of electrocardiograms (ECGs) can help track cardiac abnormalities in patients' conditions and make an earlier clinical decision. It is crucial for nurses working in critical care environments to acquire ECG knowledge for effective ECG monitoring and act accordingly in case of a change in patient condition. This study aimed at investigating intensive care unit (ICU) nurses' knowledge and attitude towards ECG interpretation in Fujian province, China. The study also analyzed the relationship between participants' demographic characteristics and level of ECG knowledge. This study was done online at twenty-one hospitals in Fujian province using a quantitative cross-sectional design involving 357 registered nurses working in the ICU between October and December 2021. The selection of hospitals and potential participants involved purposive and convenient sampling methods, respectively. Binary logistic regression was carried out to determine factors that predict ICU nurses' knowledge of ECG interpretation, and a p-value <0.05 was deemed statistically significant. The majority of nurses (70.9%) demonstrated a low level of ECG knowledge. The mean score for ECG knowledge was 5.95 (SD = 2.14), with only 0.8% of ICU nurses answering all questions correctly. The majority portrayed positive attitude towards ECG interpretation; however, more than half (61.6%) believed that nurses should rely on a doctor's opinion about ECG interpretation. Previous ECG training (AOR = 3.98, 95% CI: 2.12-7.45); frequency of ECG interpretation in comparison with no frequency of ECG interpretation (1-3 times per day: AOR = 15.55, 95% CI: 6.33-38.18; 1-3 times per week: AOR = 18.10, 95% CI: 6.38-51.34); and current working unit in comparison to those working in cardiac ICU (general ICU: AOR = 0.45, 95% CI: 0.21-0.94; medical ICU; AOR = 0.28, 95% CI: 0.12-0.67; and surgical ICU; AOR = 0.05, 95% CI: 0.01-0.43) remained statistically significant after adjusting for confounders. The present study revealed a low level of knowledge about ECG interpretation among ICU nurses. Although the participants demonstrated positive attitudes toward ECG interpretation, the negative attitude still existed. Nurses should acknowledge ECG interpretation as part of their duties and responsibilities in nursing care instead of merely relying on doctors' opinions.

How Many Echocardiograms Should be Performed to Detect One Cardiac Abnormality in Patients &lt;18 Years? Results from the “Performing Echocardiography to Detect Heart Disease (PED-HEART) Study”

Introduction: Echocardiography is an important cardiac investigating tool, however, its appropriate use in patients &lt;18 years has to be ascertained. Aim: The aim of this study was to assess the clinical indication of the referral for echocardiography in patients with abnormal and normal echocardiographic examination. Methods: Single-center, retrospective observational analysis was done in patients &lt;18 years who underwent echocardiography. This included patients’ clinical profiles and echocardiography examination findings. Results: Out of 7500 patients, normal echocardiography examinations (Group 1) were found in 75.33% (n = 5650) of the patients. Out of these (Group 1), 32.8% were referred for electrocardiographic changes, while 25% and 31% were for palpitation and chest pain, respectively. Patients with trivial findings on echocardiography were 350 (Group 2). Patients with a significant abnormality on echocardiography requiring medical management (Group 3) or cardiac intervention (Group 4) were 1250 and 250, respectively. The comparison of Group A (combined Groups 1 and 2 patients) with Group B (combined Groups 3 and 4 patients) showed that the referrals made for murmur, suspected heart failure, chest X-ray abnormalities, abnormal blood pressure/shock, and multiple parameters were found to be an independent predictor of abnormal findings on echocardiography. Conclusion: Abnormal findings on echocardiography requiring cardiac intervention in patients &lt;18 years is one in every five echocardiograms performed in this study. The implementation of appropriate use criteria for echocardiography may help in improving this ratio.

Classification of cardiac disorders based on electrocardiogram data using a decision tree classification approach with the C45 algorithm

&lt;p&gt;The limitations of medical personnel, especially heart disease, cause difficulties in diagnosing heart disorders, so diagnosing heart disorders is not easy, it takes the ability and experience of a cardiologist who has the expertise and experience to be able to accurately diagnose heart disorders. Several studies in the field of computing have been carried out in diagnosing cardiac abnormalities in patients. This study was conducted to accurately test the results of the classification of heart disorders using electrocardiogram medical record data with a C.45 decision tree approach. The results showed that the classification of heart defects obtained a mean squared error (MSE) value of 0.24, a root mean squared error (RMSE) value of 0.49, and an accuracy value of 75.33% with the C4.5 algorithm.&lt;/p&gt;

Effects of Incretin-Based Treatment on the Diastolic (Dys)Function in Patients with Uncontrolled Type 2 Diabetes Mellitus: A Prospective Study with 1-Year Follow-Up.

Left ventricular diastolic dysfunction (DD) is a subclinical cardiac abnormality in patients with type 2 diabetes mellitus (T2DM) that can progress to heart failure (HF) and increase cardiovascular risk. This prospective study evaluated the DD in T2DM patients without atherosclerotic cardiovascular disease after one year of incretin-based drugs added to standard treatment. Of the 138 enrolled patients (49.30% male, mean age 57.86 ± 8.82, mean T2DM history 5 years), 71 were started on dipeptidyl peptidase-4 inhibitor sitagliptin/saxagliptin, 21 on glucagon-like peptide-1 receptor agonist exenatide, and 46 formed the control group (metformin and sulphonylurea/acarbose). At baseline, 71 patients had grade 1 DD, another 12 had grade 2 and 3 DD, and 15 had indeterminate DD. After one year, DD was evidenced in 50 cases. Diastolic function improved in 9 cases, and 27 patients went from grade 1 to indeterminate DD. The active group benefited more, especially patients treated with exenatide; their metabolic and inflammation profiles also improved the most. An in-depth analysis of echocardiographic parameters and paraclinical results in the context of literature data justifies the conclusion that early assessment of diastolic function in T2DM patients is necessary and the benefits of affordable incretin-based treatment may extend to subclinical cardiovascular manifestations such as DD.

Cardiac MRI Findings in Patients Clinically Referred for Evaluation of Post-Acute Sequelae of SARS-CoV-2 Infection.

Persistent or recurrent cardiovascular symptoms have been identified as one of the hallmarks of long-COVID or post-acute sequelae of SARS-CoV-2 infection (PASC). The purpose of this study was to determine the prevalence and extent of cardiac abnormalities in patients referred for cardiac MRI due to clinical evidence of PASC. To investigate this, two tertiary care hospitals identified all patients who were referred for cardiac MRI under the suspicion of PASC in a 2-year period and retrospectively included them in this study. Patients with previously known cardiac diseases were excluded. This resulted in a total cohort of 129 patients (63, 51% female; age 41 ± 16 years). The majority of patients (57%) showed normal cardiac results. No patient had active myocarditis or an acute myocardial infarction. However, 30% of patients had evidence of non-ischemic myocardial fibrosis, which exceeds the prevalence in the normal adult population and suggests that a possible history of myocarditis might explain persistent symptoms in the PASC setting.

Incidence of cardiac anomalies in congenital vertebral deformity: systematic review and meta-analysis of 2910 patients.

This study aimed to analyze the overall incidence of cardiac abnormalities in patients with congenital scoliosis and the possible influencing factors. PubMed, Embase, and Cochrane Library were searched for relevant studies. The quality of the studies was assessed independently by two authors using the methodological index for nonrandomized studies (MINORS) criteria. The following data were extracted from the included studies: bibliometric data, number of patients, number of patients with cardiac anomalies, gender, types of deformity, diagnostic method, type of cardiac anomaly, location, and other associated anomalies. The Review Manager 5.4 software was used to group and analyze all the extracted data. This meta-analysis included nine studies and identified that 487 of 2,910 patients with congenital vertebral deformity had cardiac anomalies diagnosed by ultrasound (21.05%, 95% CI of 16.85-25.25%). The mitral valve prolapse was the most frequent cardiac anomaly (48.45%) followed by an unspecified valvular anomaly (39.81) and an atrial septal defect (29.98). A diagnosis of cardiac anomalies was highest in Europe (28.93%), followed by USA (27.21%) and China (15.33%). Females and formation defects were factors significantly associated with increased incidence of cardiac anomalies: 57.37%, 95% CI of 50.48-64.27% and 40.76%, 95% CI of 28.63-52.89%, respectively. Finally, 27.11% presented associated intramedullary anomalies. This meta-analysis revealed that the overall incidence of cardiac abnormalities detected in patients with congenital vertebral deformity was 22.56%. The incidence rate of cardiac anomalies was higher in females and those with formation defects. The study offers guidance for ultrasound practitioners to accurately identify and diagnose the most common cardiac anomalies.

Identification of an increased lifetime risk of major adverse cardiovascular events in UK Biobank participants with scoliosis

BackgroundStructural changes caused by spinal curvature may impact the organs within the thoracic cage, including the heart. Cardiac abnormalities in patients with idiopathic scoliosis are often studied post-corrective surgery or...

Altered serum bile acid composition is associated with cardiac dysfunction in cirrhosis.

Elevated serum bile acids (BA) are harmful to the heart and alterations in the BA composition have been suggested to cause cardiovascular disturbances in cirrhosis. To investigate any associations between specific groups or individual serum BA and structural and functional cardiac abnormalities in patients with cirrhosis. An explorative study in 86 patients with cirrhosis. All participants underwent extensive cardiac assessment, including cardiac MRI with quantification of myocardial extracellular volume (ECV), which is indicative of diffuse myocardial fibrosis. A panel of 15 individual serum BA and C4, a marker of de novo bile acid synthesis, were assessed. Patients with advanced cirrhosis had higher levels of total BA and conjugated BA, as well as lower C4 levels (p < 0.001). Conjugated BA levels were higher in patients with a high cardiac index (p < 0.001), increased left atrial volume index (LAVI) (p < 0.001), and in those with an abnormal myocardial ECV (p < 0.05). We also found several strong correlations between conjugated BA, both as a group and individually, and parameters of cardiac dysfunction. In a model adjusted for sex, age, BMI and MELD, conjugated BA remained significantly associated with LAVI, septal e', left ventricular volumes and cardiac index. In addition, taurocholic acid correlated closely with hepatic venous pressure gradient (HVPG) (p = 0.01). Increased serum concentrations of conjugated BA are associated with several cardiac parameters, indicating a potential role in the development of hyperdynamic circulation and cardiac dysfunction in cirrhosis. Moreover, taurine-conjugated BA are associated with portal hypertension.

Asymptomatic Cardiac abnormality in Patients Undergoing Low to Intermediate Risk Elective Noncardiac Surgery, Is it a Relevant Clinical Dilemma?

Asymptomatic Cardiac abnormality in Patients Undergoing Low to Intermediate Risk Elective Noncardiac Surgery, Is it a Relevant Clinical Dilemma?

Abstract 15878: Relationship Between Cardiac Biomarkers and Echocardiographic Parameters of Cardiac Structure in Patients With Diabetes

Introduction: Current guidelines recommend N-terminal pro-brain natriuretic peptide (NT-proBNP) screening to identify subclinical structural cardiac abnormalities in patients at risk for developing clinical heart failure (HF) such as those with diabetes (DM). High-sensitivity cardiac troponin (hs-cTn) is another cardiac biomarker that can predict incident HF in patients with DM. It is unclear how the addition of hs-cTn to NT-proBNP screening impacts the detection of subclinical abnormalities of cardiac structure in patients with DM. Methods: Participants with DM but without known CVD at visit 5 (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) study who had available cardiac biomarker data and detailed echocardiographic assessment were included. The associations of abnormal hs-cTn and/or NT-proBNP (defined as hs-cTn ≥ 6 ng/L and NT-proBNP ≥ 125 pg/mL) with abnormal echocardiographic measures of cardiac structure were assessed using multivariable adjusted linear regression analysis. Results: Participants (N=797, mean age 75±5y, 43% male, 77% White) had mean BMI 31±6 kg/m 2 , systolic blood pressure 129±17 mmHg, and serum creatinine 1.0±0.3 mg/dL. As shown in the table, abnormal NT-proBNP was associated with higher left ventricular (LV) mass, LV end-diastolic volume (EDV), left atrial (LA) volume, and E/A ratio. Abnormal hs-cTn was associated with lower global longitudinal strain (GLS), but no other measures of cardiac structure. The combination of abnormal hs-cTn and NT-proBNP was associated with higher LV EDV and LA volume and lower GLS. Conclusion: Among participants with DM free of CVD, abnormal NT-proBNP was associated with several echocardiographic parameters of abnormal cardiac structure. The addition of hs-cTn to NT-proBNP did not significantly improve detection of structural cardiac abnormalities other than low GLS.