Determinants of Subclinical Diabetic Heart Disease

Patients with type 2 diabetes, subclinical left ventricular dysfunction is common and associated with poor diabetic control.

Subclinical left ventricular (LV) dysfunction has been shown by tissue Doppler and strain imaging in diabetic patients in the absence of coronary disease or LV hypertrophy, but the prevalence and aetiology of this finding remain unclear.
This study sought to identify the prevalence and the determinants of subclinical diabetic heart disease.

A group of 219 unselected patients with type 2 diabetes without known cardiac disease underwent resting and stress echocardiography. After exclusion of coronary artery disease or LV hypertrophy, the remaining 120 patients (age 57+/-10 years, 73 male) were studied with tissue Doppler imaging. Peak systolic strain of each wall and systolic (Sm) and diastolic (Em) velocity of each basal segment were measured from the three apical views and averaged for each patient.
Significant subclinical LV dysfunction was identified according to Sm and Em normal ranges adjusted by age and sex. Strain and Em were correlated with clinical, therapeutic, echocardiographic and biochemical variables, and significant independent associations were sought using a multiple linear regression model.

The results showed a significant subclinical LV dysfunction was present in 27% diabetic patients. Myocardial systolic dysfunction by peak strain was independently associated with glycosylated hemoglobin level (p<0.001) and lack of angiotensin-converting enzyme inhibitor treatment (p=0.003). Myocardial diastolic function (Em) was independently predicted by age, hypertension, insulin and metformin treatment.

It was concluded that in patients with type 2 diabetes, subclinical LV dysfunction is common and associated with poor diabetic control, advancing age, hypertension and metformin treatment; ACE inhibitor and insulin therapies appear to be protective.

Diabetologia. 2005 Jan 8; [Epub ahead of print]

================================

Where’s your pedometer?
Not sure? Find out what you’re missing on the road to better health. A pedometer without a program is like a computer without any software.
https://www.rx4betterhealth.com/steptracker/