scholarly journals Development of a nomogram for predicting the risk of left ventricular diastolic function in subjects with type-2 diabetes mellitus

Author(s):  
Yuan Chen ◽  
Meng Yu ◽  
Yalin Lan ◽  
Fei Feng ◽  
Chengyan Jiang

AbstractLeft ventricular diastolic dysfunction (LVDD) can be affected by many factors, including epicardial adipose tissue (EAT), obesity and type-2 diabetes mellitus (T2DM). The aim of this study was to establish and validate an easy-to-use nomogram that predicts the severity of LVDD in patients with T2DM. This is a retrospective study of 84 consecutive subjects with T2DM admitted to the Endocrinology Department, the First People’s Hospital of Zunyi City between January 2015 and October 2020. Several echocardiographic characteristics were used to diagnose diastolic dysfunction according to the 2016 diastolic dysfunction ASE guidelines. Anthropometric, demographic, and biochemical parameters were collected. Through a least absolute shrinkage and selection operator (LASSO) regression model, we reduced the dimensionality of the data and determined factors for the nomogram. The mean follow-up was 25.97 months. Cases were divided into two groups, those with LVDD (31) and those without (53). LASSO regression identified total cholesterol (Tol.chol), low-density lipoprotein (LDL), right ventricular anterior wall (RVAW) and epicardial adipose tissue (EAT) were identified as predictive factors in the nomogram. The ROC curve analysis demonstrated that the AUC value for most clinical paramerters was higher than 0.6. The nomogram can be used to promote the individualized prediction of LVDD risk in T2DM patients, and help to prioritize patients diagnosed with echocardiography.

2017 ◽  
Vol 125 (09) ◽  
pp. 598-602 ◽  
Author(s):  
Zihang Wang ◽  
Yuhong Zhang ◽  
Weiwei Liu ◽  
Benli Su

AbstractThe present study aimed to evaluate the diagnostic value of echocardiography in measuring the thickness of epicardial adipose tissue (EAT) of the patients of type 2 diabetes mellitus (T2DM) and its correlation with the intimal-medial thickness of the carotid artery (cIMT) to investigate the relationship between EAT and cIMT. 68 patients of T2DM were enrolled and were divided into 2 groups: group of T2DM with duration≤10 years (35 cases) and group of T2DM with duration>10 years (33 cases). And 30 healthy subjects were enrolled as the control group. The thickness of EAT and cIMT were measured by echocardiography and high-frequency ultrasonography. The thickness of EAT and IMT of the carotid artery of 2 type 2 diabetic groups (duration≤10 years and>10 years) were significantly higher than that of the control group (all p<0.05), and the thickness of EAT and cIMT of the group of T2DM with duration>10 years were significantly higher than that of the group of T2DM with duration≤10 years (p<0.05). In univariate analysis, the thickness of EAT was positively and significantly associated with age (r=0.412, p<0.05), BMI (r=0.566, p<0.05), waist circumference (r=0.475, p<0.05), LDL (r=0.425, p<0.05), TG (r=0.496, p<0.05), duration of diabetes (r=0.384, p<0.05) and cIMT (r=0.456, p<0.05). In multiple stepwise regression analyses, age, BMI and IMT of carotid artery were appeared to be significantly associated with EAT (p<0.05 for all). In conclusion, routine screening of EAT and cIMT by ultrasonography in type 2 diabetic patients helps us to predict cardiovascular risks and prevent further development of cardiovascular complications.


Author(s):  
Swapnil Jain ◽  
C. L. Nawal ◽  
Amandeep Singh ◽  
Radhey Shyam Chejara ◽  
Sagar Barasara ◽  
...  

Background: Diastolic dysfunction in patients suffering from diabetes mellitus represents an earlier stage in the natural history of cardiomyopathy. This study was done to assess the left ventricular diastolic dysfunction in recently diagnosed (<5yr) Type 2 Diabetes Mellitus by Echocardiography and also to determine association of glycemic status (by HBA1c levels) with left ventricular diastolic dysfunction (LVDD).Methods: An observational descriptive study involving 100 diabetic patients, taken on first come first serve basis after applying inclusion and exclusion criteria. In all the subjects, other than routine investigations, HbA1c was estimated and echocardiography was done to evaluate LVDD.Results: Mean value of HbA1c in the study was 8.31+ 1.408 %. 63 out of 100 subjects had LVDD. There was significant positive correlation between HbA1c and LVDD (p value <0.001). As HbA1c increased, severity of LVDD increased. In this study, as BMI increased, HbA1c and LVDD increased & both findings were statistically significant (p value =0.001).Conclusion: Our study indicates that myocardial damage in patients with diabetes affects diastolic function before systolic function &higher HbA1C level is strongly associated with presence of LVDD. Patients should be advised strict control of diabetes in order to reduce the risk for developing LVDD which is a precursor for more advanced disease.Keywords: Diabetes mellitus, Diastolic dysfunction, BMI, HbA1c


Author(s):  
Ismail Baloglu ◽  
Kultigin Turkmen ◽  
Nedim Selcuk ◽  
Halil Tonbul ◽  
Adalet Ozcicek ◽  
...  

Abstract Introduction and aim Cardiovascular diseases remain the most common cause of morbidity and mortality in patients with diabetes. Epicardial adipose tissue (EAT), visceral fat depot of the heart, was found to be associated with coronary artery disease in cardiac and non-cardiac patients. Increased visceral adiposity is associated with proinflammatory activity, impaired insulin sensitivity, increased risk of atherosclerosis and high mortality. In the present study we aimed to investigate the relationship between EAT and visceral adiposity index (VAI) in patients with diabetes. Methods This was a cross-sectional study involving 128 patients with type 2 diabetes mellitus (73 females, 55 males; mean age, 54.09+±+9.17 years) and 32 control subjects (23 females, 9 males; mean age, 50.09+±+7.81 years). EAT was measured by using a trans-thoracic echocardiograph. Parameters such as waist circumference (WC), body mass index (BMI), triglyceride and high density lipoprotein (HDL) cholesterol were used to calculate VAI. Result EAT and VAI measurements were significantly higher in patients with diabetes when compared to control subjects. In the bivariate correlation analysis, VAI was positively correlated with uric acid level (r=0.214, p=0.015), white blood cell count (r= 0.262, p=0.003), platelet count (r=0.223, p=0.011) and total cholesterol levels (r= 0.363, p<0.001). Also, VAI was found to be the independent predictor of EAT. Conclusion Simple calculation of VAI was found to be associated with increased EAT in patients with type 2 diabetes.


2015 ◽  
Vol 61 (2) ◽  
pp. 21-27
Author(s):  
I P Tatarchenko ◽  
N V Pozdnyakova ◽  
A G Denisova ◽  
O I Morozova

The present study was focused on the assessment of electrophysiological, structural, and functional characteristics of the heart associated with ventricular rhythm disturbances in the patients with type 2 diabetes mellitus (DM2) suffering from diastolic cardiac insufficiency. The study involved a total of 128 patients with DM2 and coronary heart disease (CHD) exhibiting signs of functional class I-III chronic cardiac insufficiency and left ventricular ejection fraction over 50%. The patients were divided into three groups. Group 1 (n=55) included patients presenting with left ventricular relaxation. Group 2 (n=44) was comprised of the patients with the pseudo-normal type of diastolic dysfunction. Group 3 (n=29) consisted of the patients with restrictive diastolic dysfunction. The patients of the latter group were characterized by the high frequency of complicated forms of ventricular arrhythmia, such as Grade IV-V ventricular extrasystole (48.3%) and Grade III ventricular extrasystole (34.5%). Restrictive type of diastolic dysfunction was associated with the delayed fragmented activity in the end part of the ventricular complex in 72.4% of the patients. The close correlation between the left ventricular diastolic function and parameters of myocardial electrical remodeling was documented.


Circulation ◽  
2012 ◽  
Vol 126 (19) ◽  
pp. 2324-2334 ◽  
Author(s):  
Sabrina Greulich ◽  
Bujar Maxhera ◽  
Guy Vandenplas ◽  
Daniella Herzfeld de Wiza ◽  
Konstantinos Smiris ◽  
...  

Author(s):  
Zengfa Huang ◽  
Jianwei Xiao ◽  
Zuoqin Li ◽  
Yun Hu ◽  
Yuanliang Xie ◽  
...  

Background: Left ventricular diastolic dysfunction (LVDD) is a common abnormality among patients in T2DM. Aim: We aimed to evaluate the feasibility of coronary computed tomography angiography (CCTA) for the assessment of LVDD in type 2 diabetes mellitus (T2DM) patients. Methods: 80 consecutive T2DM patients who were referred for a clinically dual-source CCTA examination to evaluate suspected coronary artery disease and also underwent 2D echocardiography within 7 days of CCTA inclusion and exclusion criteria, were performed. Correlation between CCTA and echocardiography was tested through linear regression and Bland-Altman analysis. Results: In total, 60 T2DM patients were included for the analysis. Pearson correlation showed good correlation for E (r = 0.28; P = 0.028), E/A (r = 0.69; P < 0.01); E (r = -0.06; P = 0.776), E/A (r = 0.54; P = 0.003) and E (r = 0.64; P < 0.01), E/A (r = 0.83; P < 0.01) in three groups, respectively. Overall, diagnostic accuracy for assessment in CCTA of diastolic dysfunction was 79.76% (95% CI: 68%-91%), 71.43% (95% CI: 58%-85%) and 87.50 (95% CI: 79%-96%) in three groups. Conclusion: The presented study proved that CCTA showed good correlations in the estimation of LV filling pressures compared with echocardiography in T2DM patients. Accordingly, retrospectively ECG-gated CCTA may provide valuable information on the evaluation of LVDD in T2DM patients.


2015 ◽  
Vol 39 (5) ◽  
pp. 405 ◽  
Author(s):  
Do Kyeong Song ◽  
Young Sun Hong ◽  
Hyejin Lee ◽  
Jee-Young Oh ◽  
Yeon-Ah Sung ◽  
...  

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