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Research Article: Identifying a high-risk CKM syndrome phenotype: association of albuminuria with subclinical hemodynamic alterations via portable noninvasive cardiometer

Date Published: 2026-09-29

Abstract:
Type 2 diabetes mellitus (T2DM) is closely linked to heart failure. This prospective study of 274 asymptomatic patients with T2DM without clinical heart failure or coronary artery disease used portable noninvasive cardiometry to assess hemodynamic parameters. Patients with albuminuria (n=119) showed significantly lower stroke volume and index of contractility (ICON 29.44 ± 9.48 vs 34.78 ± 10.18, p<0.0001), and higher systemic vascular resistance compared with those without albuminuria (n=155). Albuminuria remained independently associated with reduced ICON after multivariable adjustment that included sex, body mass index, and metabolic parameters. Higher BMI was also strongly associated with lower ICON. Patients with albuminuria also had a higher all-cause medical hospitalization rate (39.5% vs 24.5%) during follow-up. These findings suggest that T2DM patients with albuminuria may represent a high-risk CKM phenotype characterized by subclinical hemodynamic alterations, supporting further investigation of noninvasive approaches for early cardiovascular risk assessment.

Introduction:
T2DM is associated with several severe complications. People with diabetes have about twice the risk of HF compared with those without diabetes ( 1 ), and incidence is roughly 2–3 times higher in T2DM ( 2 ). In a modern Spanish outpatient cohort of T2D, baseline HF prevalence was 39% and 3-year incidence was 7.6% (3.0/100 person-years) ( 3 ). These two disorders frequently overlap. Recently, the American Heart Association (AHA) has integrated these interrelated conditions into a single clinical entity known as…

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