Type 2 Diabetes Patients With Coronary Disease Face Higher Mortality, Poorer Right Ventricular Function: Study Shows
China: Patients living with type 2 diabetes mellitus (T2DM) who also suffer from obstructive coronary artery disease (OCAD) are at a significantly increased risk of mortality and hospitalization due to heart failure, according to a new study published in Cardiovascular Diabetology.
The research, conducted by Dr. Jin Wang and colleagues from the Department of Radiology at West China Hospital, Sichuan University, used advanced cardiac imaging to investigate the link between right ventricular (RV) function and clinical outcomes in these high-risk patients.
"Patients with type 2 diabetes and OCAD faced a 1.91-fold higher risk of death and heart failure hospitalization compared to those without OCAD," the researchers reported. "Right ventricular strain parameters, including global longitudinal and circumferential peak strain, showed a stepwise decline from healthy controls to diabetics without OCAD, and further in those with OCAD. OCAD emerged as a strong predictor of adverse clinical outcomes."
The study analyzed data from 246 individuals with T2DM—105 with OCAD and 141 without—and compared them to 85 healthy controls. Using cardiovascular magnetic resonance (CMR), the researchers assessed RV structure and function, with a particular focus on myocardial strain parameters such as peak strain (PS) and strain rates during both systolic and diastolic phases.
The following were the key findings of the study:
- A progressive decline in right ventricular (RV) function was observed from healthy individuals to T2DM patients without OCAD, and further to those with both T2DM and OCAD.
- Key RV function markers, including global longitudinal and circumferential peak strain, as well as systolic and diastolic strain rates, were significantly impaired in the T2DM-OCAD group.
- The presence of OCAD was closely linked to worsening RV function in diabetic patients.
- Individuals with both T2DM and OCAD had a 1.91-fold increased risk of adverse outcomes, such as all-cause mortality and heart failure hospitalization, compared to those with diabetes alone.
- These associations remained consistent over a median follow-up of nearly six years.
The study highlights the value of CMR feature-tracking (CMR-FT) in detecting subtle but clinically significant impairments in RV function, especially in diabetic patients with coexisting coronary disease. According to the authors, identifying these impairments early could help refine risk stratification and guide more personalized management strategies.
“The combination of type 2 diabetes and obstructive coronary artery disease not only accelerates cardiac dysfunction but also significantly worsens prognosis,” the researchers concluded. “Assessing right ventricular function with CMR may provide critical insights into patient outcomes and inform more effective interventions.”
The study highlights the need for heightened cardiovascular monitoring in diabetic populations, particularly those with known coronary involvement. As the prevalence of diabetes continues to rise globally, these findings could contribute to more targeted approaches to preventing heart failure and reducing mortality in this vulnerable group.
Reference:
Wang, J., Yan, WF., Shi, K. et al. Comparison of right ventricular function and clinical outcomes in type 2 diabetes patients with and without obstructive coronary artery disease: insights from a CMR study. Cardiovasc Diabetol 24, 229 (2025). https://doi.org/10.1186/s12933-025-02755-z
