Introduction: Diabetic cardiomyopathy (DbCM) , a transitional phenotype that may precede overt heart failure (HF) onset, is characterized by abnormalities in cardiac structure or function in DM in the absence of cardiovascular disease (CVD) or major risk factors. Whether WATCH-DM, a validated risk score to identify incident heart failure (HF) among individuals with DM, can identify DbCM is unknown.
Methods: Adults without known prevalent CAD or overt HF were pooled from 2 community-based cohort studies (ARIC and CHS) . Presence of DbCM in patients with DM was defined using different definitions (Figure) . Adjusted logistic regression and restricted spline models were used to evaluate the association of WATCH-DM and the individual components of DbCM.
Results: Among 2,241 individuals with DM, the prevalence of DbCM was 9.8% and 62.8% applying the most and least restrictive definitions, respectively. For every 1-unit increase, the WATCH-DM score was associated with higher risk of LV hypertrophy and diastolic dysfunction (odds ratio [95% CI] = 1.20 [1.15-1.27] and 1.[1.05-1.13], respectively) , but not LA enlargement (Figure A) . Across definitions, higher WATCH-DM scores were associated with a higher risk of DbCM (Figure B) .
Conclusions: The WATCH-DM risk score is associated with higher prevalence of DbCM and may be a useful tool in screening for DbCM.
M.W.Segar: None. K.Patel: None. M.Vaduganathan: Advisory Panel; American Regent, Amgen, AstraZeneca, Bayer AG, Baxter Healthcare, Boehringer Ingelheim, Cytokinetics, Lexicon Pharmaceuticals, Pharmacosmos, Relypsa, Roche Diagnostics, and Sanofi, Other Relationship; Novartis and Galmed , Research Support; Amgen, AstraZeneca, Boehringer Ingelheim, Novartis, Roche Diagnostics, and Sanofi, Speaker's Bureau; Novartis and Roche Diagnostics. A.Chandra: None. D.L.Willett: None. A.Pandey: Advisory Panel; Lilly, Consultant; Tricog, Research Support; Applied Therapeutics, Gilead Sciences, Inc.