Premature Aging and Type 2 Diabetes Mellitus: an Increased Risk of Cardiomyopathy?

Study Overview
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Brief Summary
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The potential clinical implications of this study are to optimise the selection of a population at risk for developing a diabetic cardiomyopathy among diabetic patients in order to develop early therapeutic strategies to prevent the left ventricular remodelling. Therefore, the originality of this project is to hypothesize that : Diabetes mellitus is often associated with a premature aging syndrome Cellular senescence may potentiate the mechanisms that are involved in decreasing myocardial contractility in DM and, DM associated to premature aging may increase the risk of developing a cardiomyopathy Thus, the modulation of telomerase activity and the control of telomere length, together with the attenuation of the formation of reactive oxygen species, might represent important new targets in order to develop therapeutic tools in prevention of diabetic cardiomyopathy.

Official Title
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Premature Aging and Type 2 Diabetes Mellitus: an Increased Risk of Cardiomyopathy?

Conditions
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Type 2 Diabetes Mellitus

Intervention / Treatment
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* Other: Cardiac RMI
* Other: Analysis telomere
* Other: Stress test
* Other: echocardiography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Type 2 Diabetes mellitus 40 < Age < 55 years old oral antidiabetic or insulin treatment No symptoms Sinus rhythm no sign or history of heart disease LVEF > 55% Absence of regional left ventricular motion abnormalities. Exclusion Criteria: absence of sinus rhythm, silent ischemia defined as positive exercise test or positive stress echocardiography, history of cardiomyopathy or CAD, valvular heart disease hemodynamically significant, severe renal insufficiency defined as creatinine clearance < 30 mL/min, echocardiographic images unsuitable for quantification, type 1 diabetes mellitus, Important diabetes mellitus imbalance defined as glycated hemoglobin > 9% or glycemia > 3g/L uncontrolled hypertension (> 180/100 mmHg).

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Type 2 Diabetes Mellitus<br> | Other: Analysis telomere<br>* Analysis telomere<br>Other: Stress test<br>* Stress test<br>Other: echocardiography<br>* echocardiography<br>Other: Cardiac RMI<br>* Cardiac RMI<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Telomere shortening | Investigate whether biomarkers for senescence determined from blood samples, including telomere shortening and telomerase activity in diabetic patients have an impact of left ventricular remodelling as compared with age-matched controls and biological aged control subjects. | 36 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dysfunction by speckle tracking imaging | Study the incidence of subtle regional myocardial dysfunction by speckle tracking imaging (longitudinal and radial systolic strain) | 36 months | 
| Determine the predictive value of alteration | Determine the predictive value of alteration : Proteinuria, glycosylated haemoglobin, diabetes mellitus duration, blood pressure, BNP dosage, MRI diagnoses | 36 months | 
| Cardiovascular events | Investigate the predictive value of all those factors( telomere shortening, telomerase activity, echo abnormalities) on cardiovascular events including MI, HF, arrhythmia; ACV | 36 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diabetes mellitus, accelerated aging, cellular senescence, diabetic cardiomyopathy, strain imaging, strain rate imaging,, echocardiography