Asymptomatic Left Ventricular Dysfunction Common in Diabetics

A sizable minority of asymptomatic diabetic patients without known coronary artery disease have reduced left ventricular ejection fraction (LVEF), comes from a review of records of patients referred for stress single-photon emission computed tomography (SPECT). Dr. Panithaya Chareonthaitawee, lead investigator stated that, "One in every 6 asymptomatic diabetic patients who underwent stress SPECT and assessment of left ventricular systolic function was found to have reduced LVEF."

Dr. Chareonthaitawee added that, National guidelines, indicate that "patients who have reduced LVEF but not symptoms — stage B — can benefit clinically from ACE-inhibitor and beta-blocker therapy, along with risk factor modification."

Dr. Chareonthaitawee and colleagues examined records of 1046 asymptomatic diabetic patients — type 1 and type 2 — and found that 16.7% had a left ventricular ejection fraction of less than 50%.

These patients were older, had more peripheral arterial disease, and had a higher prevalence of electrocardiographic Q waves than did patients with a normal LVEF, the investigators report in the September issue of the American Heart Journal.
Survival at 10 years was 29% among patients with reduced LVEF versus 57% for those without the condition, and reduced LVEF was found to be independently associated with increased mortality.

The "potential to reduce heart failure and improve outcome suggests the potential role of screening for the preclinical stages of reduced LVEF," continued Dr. Chareonthaitawee.

"However, this study was not randomized, did not address exactly who to screen, and the financial implications are enormous — so larger studies are needed."

Am Heart J 2007;154:567-574.

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DID YOU KNOW:
Hemoglobin A1c Levels Effective Screening Test for Diabetes:  Measuring patients’ glycosylated hemoglobin levels (A1C) could be used to screen for diabetes, according to California-based researchers.  It was shown to be more effective then using fasting blood sugars. See this week’s Item #

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