Diabetes and Myocardial Fibrosis: A Systematic Review and Meta-Analysis

source extracted confidence: high 2026-04-09
#cardiomyopathies #diabetes-mellitus-type-2 #fibrosis #humans #magnetic-resonance-imaging-cine

Diabetes and Myocardial Fibrosis: A Systematic Review and Meta-Analysis

Salvador et al., 2022 | JACC Cardiovasc Imaging | Meta Analysis

Citation

Salvador Dante B, Gamba Magda R, ... Bano Arjola. Diabetes and Myocardial Fibrosis: A Systematic Review and Meta-Analysis. JACC Cardiovasc Imaging. 2022-May;15(5):796-808. doi:10.1016/j.jcmg.2021.12.008

Abstract

OBJECTIVES: This systematic review and meta-analysis investigated the association of diabetes and glycemic control with myocardial fibrosis (MF). BACKGROUND: MF is associated with an increased risk of heart failure, coronary artery disease, arrhythmias, and death. Diabetes may influence the development of MF, but evidence is inconsistent. METHODS: The authors searched EMBASE, Medline Ovid, Cochrane CENTRAL, Web of Science, and Google Scholar for observational and interventional studies investigating the association of diabetes, glycemic control, and antidiabetic medication with MF assessed by histology and cardiac magnetic resonance (ie, extracellular volume fraction [ECV%] and T1 time). RESULTS: A total of 32 studies (88% exclusively on type 2 diabetes) involving 5,053 participants were included in the systematic review. Meta-analyses showed that diabetes was associated with a higher degree of MF assessed by histological collagen volume fraction (n = 6 studies; mean difference: 5.80; 95% CI: 2.00-9.59) and ECV% (13 studies; mean difference: 2.09; 95% CI: 0.92-3.27), but not by native or postcontrast T1 time. Higher glycosylated hemoglobin levels were associated with higher degrees of MF. CONCLUSIONS: Diabetes is associated with higher degree of MF assessed by histology and ECV% but not by T1 time. In patients with diabetes, worse glycemic control was associated with higher MF degrees. These findings mostly apply to type 2 diabetes and warrant further investigation into whether these associations are causal and which medications could attenuate MF in patients with diabetes.

Key Findings

A total of 32 studies (88% exclusively on type 2 diabetes) involving 5,053 participants were included in the systematic review. Meta-analyses showed that diabetes was associated with a higher degree of MF assessed by histological collagen volume fraction (n = 6 studies; mean difference: 5.80; 95% CI: 2.00-9.59) and ECV% (13 studies; mean difference: 2.09; 95% CI: 0.92-3.27), but not by native or postcontrast T1 time. Higher glycosylated hemoglobin levels were associated with higher degrees of MF

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population diabetes
Sample Size 6
Age Range See abstract
Condition diabetes

MeSH Terms

  • Cardiomyopathies
  • Diabetes Mellitus, Type 2
  • Fibrosis
  • Humans
  • Magnetic Resonance Imaging, Cine
  • Myocardium
  • Predictive Value of Tests

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review, Research Support, Non-U.S. Gov't
  • Vertical: collagen

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09