Diastolic dysfunction is associated with anaemia in patients with Type II diabetes

2005 ◽  
Vol 110 (1) ◽  
pp. 109-116 ◽  
Author(s):  
Piyush M. Srivastava ◽  
Merlin C. Thomas ◽  
Paul Calafiore ◽  
Richard J. MacIsaac ◽  
George Jerums ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Cardiac Dysfunction ◽  
Type Ii Diabetes ◽  
Systolic Dysfunction ◽  
Cardiac Risk ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Type Ii ◽  
Increased Risk ◽  
Patients With Diabetes

Anaemia is common in patients with diabetes and associated with an increased risk of diabetic complications. Although the role of anaemia in heart failure is established, we hypothesize that anaemia also contributes to an increased risk of cardiac dysfunction in patients with Type II diabetes. In the present study, 228 consecutive adults with diabetes were investigated using transthoracic echocardiography. Echocardiographic parameters were correlated with the Hb (haemoglobin) level and adjusted for other risk factors for cardiac dysfunction using multivariate analysis. More than one in five patients (23%) had anaemia, which was an independent risk factor for cardiac dysfunction on echocardiography. Over one-third of all patients with evidence of abnormal cardiac function (diastolic and/or systolic dysfunction) on echocardiography had anaemia compared with <5% of patients with normal echocardiographic findings. Most patients with anaemia had cardiac dysfunction (94%), with the major abnormality being diastolic dysfunction associated with an increased left ventricular mass and impaired relaxation indices. A continuous association between diastolic function and Hb was also observed in patients without anaemia. In patients with a history of cardiovascular disease, systolic dysfunction was twice as common in patients with anaemia. Anaemia was also correlated with plasma markers of cardiac risk, including BNP (brain natriuretic peptide), CRP (C-reactive protein) and AVP (arginine vasopressin). Notably, the predictive utility of these markers was eliminated after adjusting for Hb. Consequently, the inexpensive measurement of Hb may be a useful tool to identify diabetic patients at increased risk of cardiac dysfunction.

scholarly journals Prevalence of left ventricular diastolic dysfunction by echocardiography in type II diabetes mellitus patients

2019 ◽  
Vol 6 (4) ◽  
pp. 1334
Author(s):  
Ansari Mohammed Shoeb Himayun Kabeer ◽  
Shaikh Ambreen Fatema Abdul Hafiz
Keyword(s):  
Diastolic Dysfunction ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Type Ii ◽  
Type 2 Dm ◽  
Ventricular Diastolic Dysfunction

Background: Epidemiological data indicates a greater risk of cardiovascular morbidity and mortality, particularly congestive heart failure in diabetic patients, compared with nondiabetic patients. Heart failure in many patients is due to left Ventricular Diastolic Dysfunction (LVDD), but its prevalence among diabetic adults is still not known, especially in the primary health care settings. Present study aims to evaluate the prevalence of LVDD by Echocardiography in Type II Diabetes Mellitus (DM).Methods: Authors did a prospective study, from May 2012 to August 2014, in Department of Medicine, Dr. D. Y. Patil Hospital, Kolhapur which included 100 randomly selected patients of Type II DM. The diagnosis of Type II DM was done according to the criteria laid down by American Diabetes Association 2012. A detailed clinical history was taken using a structured questionnaire prepared by us and all patients were evaluated for left ventricular function by Echocardiography. Equipment used for echocardiography-Mind ray DC USG, Doppler machine Probe used-7.5MHz.Results: On Echocardiography, Diastolic Dysfunction was found to be prevalent among individuals with Type 2 DM. Duration of DM and increasing age were found to be significantly associated with presence of Diastolic Dysfunction among individuals with Type 2 DM. Maximum number of patients were observed in the age group 51-60 years in our institute. 45% of the patients were asymptomatic, rest of the patients had predominantly cardiac symptoms.Conclusions: It is essential to screen diabetic patients with Echocardiography at an early stage to prevent future cardiovascular complications.

scholarly journals Cardiac adipose tissue volume and IL-6 level at admission are complementary predictors of severity and short-term mortality in COVID-19 diabetic patients

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Franck Phan ◽  
Samia Boussouar ◽  
Olivier Lucidarme ◽  
Mohamed Zarai ◽  
Joe-Elie Salem ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Intensive Care ◽  
Interleukin 6 ◽  
Type Ii Diabetes ◽  
Troponin T ◽  
Early Mortality ◽  
Diabetic Patients ◽  
Type Ii ◽  
Short Term ◽  
Increased Risk

Abstract Background COVID-19 diabetic adults are at increased risk of severe forms irrespective of obesity. In patients with type-II diabetes, fat distribution is characterized by visceral and ectopic adipose tissues expansion, resulting in systemic inflammation, which may play a role in driving the COVID-19 cytokine storm. Our aim was to determine if cardiac adipose tissue, combined to interleukin-6 levels, could predict adverse short-term outcomes, death and ICU requirement, in COVID-19 diabetic patients during the 21 days after admission. Methods Eighty one consecutive patients with type-II diabetes admitted for COVID-19 were included. Interleukin-6 measurement and chest computed tomography with total cardiac adipose tissue index (CATi) measurement were performed at admission. The primary outcome was death during the 21 days following admission while intensive care requirement with or without early death (ICU-R) defined the secondary endpoint. Associations of CATi and IL-6 and threshold values to predict the primary and secondary endpoints were determined. Results Of the enrolled patients (median age 66 years [IQR: 59–74]), 73% male, median body mass index (BMI) 27 kg/m2 [IQR: 24–31]) 20 patients had died from COVID-19, 20 required intensive care and 41 were in conventional care at day 21 after admission. Increased CATi and IL-6 levels were both significantly related to increased early mortality (respectively OR = 6.15, p = 0.002; OR = 18.2, p < 0.0001) and ICU-R (respectively OR = 3.27, p = 0.01; OR = 4.86, p = 0.002). These associations remained significant independently of age, sex, BMI as well as troponin-T level and pulmonary lesion extension in CT. We combined CATi and IL-6 levels as a multiplicative interaction score (CATi*IL-6). The cut-point for this score was ≥ 6386 with a sensitivity of 0.90 and a specificity of 0.87 (AUC = 0.88) and an OR of 59.6 for early mortality (p < 0.0001). Conclusions Cardiac adipose tissue index and IL-6 determination at admission could help physicians to better identify diabetic patients with a potentially severe and lethal short term course irrespective of obesity. Diabetic patients with high CATi at admission, a fortiori associated with high IL-6 levels could be a relevant target population to promptly initiate anti-inflammatory therapies.

Abstract P355: Prevalence of Diastolic Dysfunction With Preserved Left Ventricular Systolic Function in Hypertensive and Type II Diabetic Patients in a Large Community Practice in Greenville, South Carolina

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Naveen R Saxena ◽  
Juhi Saxena ◽  
Anju Saxena ◽  
Vinita Srivastava
Keyword(s):  
Diastolic Dysfunction ◽  
Wave Velocity ◽  
Systolic Function ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Community Practice ◽  
Type Ii ◽  
Sex Distribution ◽  
Hypertensive Patients

Diastolic dysfunction with preserved left ventricle systolic function is a major cause for adverse cardiovascular events in hypertensive and Type II Diabetic patients. Review of medical literature reveals prevalence of diastolic dysfunction in the range of 20 to 60 percent in hypertensive and diabetic patients. The aim of this study is to examine prevalence of diastolic dysfunction with normal systolic function in hypertensive and Type II Diabetic patients in a community practice. This is a retrospective chart review of 3085 hypertensive and 899 type II Diabetic patients. All patients underwent 2D color Doppler studies for the evaluation of diastolic dysfunction using American Society of Echocardiography criteria. E wave velocity, A wave velocity, E to A ratios, and deceleration time were measured. Patients with known systolic heart failure were excluded from the study. The age distribution of the patients in the study ranged from 45 to 85 years with a mean age of 65 years. The sex distribution of the hypertensive patients were 45% male and 55% female. The sex distribution of Type II Diabetic patients were 44% male and 56% female. Given the data, we conclude prevalence of diastolic dysfunction in hypertensive patients is 29% and prevalence of diastolic dysfunction in type II Diabetic patients is 33%. Echocardiography is an excellent tool to risk stratify hypertensive and type II Diabetic patients. Aggressive management of this high-risk group may reduce cardiovascular mortality and morbidity.

scholarly journals P282 Left ventricular diastolic dysfunction in asymptomatic type 2 diabetes mellitus with preserved systolic function

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Mouadili ◽  
M Sebani ◽  
C Mbauchy ◽  
M El Hattaoui ◽  
S El Karimi
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Systolic Function ◽  
Stress Test ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Type Ii ◽  
Cross Sectional ◽  
Glucose Levels

Abstract The involvement of diabetes in the occurrence of an alteration of the diastolic function of LV is well established. The objective of our study was to evaluate the prevalence of diastolic dysfunction in Type II diabetic patients in light of the latest 2016 recommendations of the American Society of Echocardiography and to identify its associated factors. It was a cross-sectional observational study with a descriptive and analytic focus spread over a 6-month period from July to December 2017.The study included 66 asymptomatic type II diabetic patients, with a normal ECG and a negative stress test ischemia. All hypertensive subjects with an ejection fraction &lt;50%, or those with myocardial, valvular or rhythm disorder, were excluded. The mean age of our patients, was 42 years ± 9 years with extremes ranging from 39 to 84 years, we noted a female predominance (68%) with a sex ratio of 2.14. The prevalence of diastolic dysfunction was 27%. Factors associated with this change in diastolic function were advanced age (p &lt;0.0001), age of diabetes&gt; 10 years (p &lt;0.0001), glycemic imbalance with HbA1c&gt; 7% (p &lt;0) , 0001) and elevated fasting glucose levels (p = 0.039), obesity (p &lt;0.0001), dyslipidemia (p &lt;0.0001) and menopause (p = 0.002). Diastolic dysfunction affects a significant percentage of patients with type II diabetes. Therefore, we propose strict glycemic control in these patients, an early cardiographic echo screening in at-risk subjects, in order to improve their management, and to limit their progression to more serious complications.

scholarly journals Implication of Current ASE/EACVI Left Ventricular Diastolic Function Classification in Predicting 2-Year MACE in Asymptomatic Patients with Diabetes and Hypertension

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Foo ◽  
K H Lam ◽  
M Igo ◽  
M N A Sulaiman ◽  
M Y Ku ◽  
...  
Keyword(s):  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Diabetic Patients ◽  
Prognostic Impact ◽  
Left Atrial Volume Index ◽  
Asymptomatic Patients ◽  
Number Of Patients ◽  
Increased Risk ◽  
Patients With Diabetes

Abstract Background Left ventricular diastolic dysfunction (LVDD) has been shown to be more prevalent in patients with diabetes, and once progress to overt heart failure, carry worse clinical outcomes. Substantial number of patients were classified as indeterminate DF based on the current ASE/EACVI guidelines. The implication of current DF classification in predicting MACE among diabetic patients is not well established. Purpose To assess prognostic impact of current guidelines-based DF classification, and determine predictors of 2-year MACE based on individual LVDD parameters. Methods A total of 111 patients with diabetes and hypertension who attended diabetic clinic follow-up at the primary healthcare settings were enrolled. All patients had no prior cardiovascular events, had preserved left ventricular (LV) ejection fraction on echocardiography and sinus rhythm on ECG at screening. Echocardiography was performed to obtain parameters of LV dimensions, LV volumes and LVDD. The 2016 ASE/EACVI guidelines were applied to classify DF. All patients were followed up until 2 years to assess MACE. Results There were 65 (58.6%) female patients. Mean age was 59.86 (7.45); mean duration of DM was 10.5 (5.41). 80 (72.1%) patients were classified as having normal DF (nDF); 24 (21.6%) patients were classified as indeterminate DF (iDF); 7 patients (6.3%) were classified as LVDD. Patients with LVDD had significantly higher LV mass index (LVMI) (mean 121.72±23.28g/m2 vs 116.62±24.66g/m2 in iDF vs 102.50±22.89g/m2 in nDF); higher left atrial volume index (LAVI) (mean 41.24±10.28ml/m2 vs 30.55±10.07ml/m2 in iDF vs 25.75±6.30ml/m2 in nDF); lower lateral e' velocity (mean 6.35±2.05cm/s vs 7.37±1.73cm/s in iDF vs 8.59±2.13cm/s in nDF); higher septal E/e' ratio (mean 14.89±3.29 vs 12.16±3.99 in iDF vs 9.99±2.35 in nDF); higher average septal-lateral E/e' ratio (mean 14.22±3.77 vs 11.34±3.74 in iDF vs 9.04±2.10 in nDF). Among these 111 patients, 10 patients (9%) reported MACE at 2 years. The risk of 2-year MACE is elevated in both iDF [odds ratio (OR) 3.80, 95% CI 0.87–16.54, p=0.075] and LVDD [OR 7.60, 95% CI 1.11–52.02, p=0.039]. LVMI (OR 1.027, 95% CI 1.004– 1.051, p=0.023), LAVI (OR 1.092, 95% CI 1.017–1.172), and average septal-lateral E/e' ratio (OR 1.276, 95% CI 1.047–1.557, p=0.016) significantly correlated with 2-year MACE. Conclusions LVDD is correlated with increased MACE at 2 years. LVMI, LAVI and average septal-lateral E/e' ratio were predictors of increased risk of MACE at 2 years. Further investigation with larger sample size is warranted. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health Malaysia

scholarly journals Prevalence of left ventricular diastolic dysfunction among patients with asymptomatic diabetes mellitus type 2

2019 ◽  
Vol 6 (4) ◽  
pp. 1032
Author(s):  
D. Sai Vittal ◽  
M. V. Ram Babu
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Heart Failure ◽  
Strong Association ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Ventricular Diastolic Dysfunction ◽  
Patients With Diabetes ◽  
Onset Of Diabetes

Background: Diastolic heart failure occurs due to impaired myocardial relaxation and compliance. Of late, it has been suggested that the changes in the diastolic function occurs before the onset of diabetes, and present in the prediabetic patients. It is also said to be associated with insulin resistance.Methods: This observational study was performed on 50 diabetic patients, with asymptomatic type 2 diabetes. who came in for 2 D echocardiogram with suspected diastolic dysfunction.Results: The mean age among the 50 patients in the study was 54.1±10.99 years and in controls it was 49.56±10.63 years. The fasting sugar among the patients was 179.43±41.57 mg/dl and the post prandial was 236.72±76.24, and it was in the normal range in the controls. The HbA1c was 9.93±1.2 among the patients and 6.09 ± 0.34 in the controls. In the patients, the E/A ratio was 0.83±0.09 compared to 1.22±0.31 of the controls, which was highly significant as the E/e ratio which was 15.1±3.4 and 7.3±0.08 respectively.Conclusions: There was a higher prevalence of diastolic dysfunction among the patients with diabetes in our study. There was no relation of age or gender among the diabetic and the controls, while a strong association and indicators seem to be FBS, PLBS and HbA1c.

Link between diabetes and diastolic dysfunction and the diagnostic role of echocardiography

2009 ◽  
Vol 150 (45) ◽  
pp. 2060-2067 ◽  
Author(s):  
András Nagy ◽  
Zsuzsanna Cserép
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Systolic Dysfunction ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Doppler Study

Diabetes mellitus, a disease that has been reaching epidemic proportions, is an important risk factor to the development of cardiovascular complication. The left ventricular diastolic dysfunction represents the earliest pre-clinical manifestation of diabetic cardiomyopathy, preceding systolic dysfunction and being able to evolve to symptomatic heart failure. In early stages, these changes appear reversible with tight metabolic control, but as pathologic processes become organized, the changes are irreversible and contribute to an excess risk of heart failure among diabetic patients. Doppler echocardiography provides reliable data in the stages of diastolic function, as well as for systolic function. Combination of pulsed tissue Doppler study of mitral annulus with transmitral inflow may be clinically valuable for obtaining information about left ventricular filling pressure and unmasking Doppler inflow pseudonormal pattern, a hinge point for the progression toward advanced heart failure. Subsequently we give an overview about diabetes and its complications, their clinical relevance and the role of echocardiography in detection of diastolic heart failure in diabetes.

Study of Systolic and Diastolic Dysfunction among Normotensive Patients with Type 2 Diabetes Mellitus – A Cross–Sectional Study from Puducherry, India

2021 ◽  
Vol 8 (37) ◽  
pp. 3344-3349
Author(s):  
Suman Babu I.S.S. ◽  
Sethu Prabhu Shankar ◽  
Harshavardhan Reddy ◽  
Surya Usha Surendran Nair
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Control Group ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
A Value

BACKGROUND Diabetes mellitus (DM) single-handedly accounts for 75 – 90 % of excess coronary artery disease (CAD) risk seen in persons suffering from it and it also enhances and amplifies the effects of other traditional cardiovascular risk factors. After adjusting for concomitant risk factors such as hypertension and hyperlipidemia, there still remains an excess risk for cardiovascular disease (CVD) in people with diabetics. In this study, we wanted to evaluate left ventricular (LV) systolic and diastolic dysfunction in normotensive diabetic patients. METHODS A cross sectional comparative study was performed from January 2016 to September 2017 on 50 diabetics and 50 age and sex matched healthy controls. Adult patients of both sexes with diabetes mellitus who are normotensive were included as cases. Patients with known heart disease, chronic kidney disease, thyroid disorders were excluded from the study. 2D transthoracic echocardiogram (ECHO) with M mode was used for assessing systolic and diastolic function. RESULTS Mean ejection fraction was lower in patients group (59.76) as compared to control group (64.74) with 8 % of cases with a value of< 50 %. Fractional shortening was also lower in patients (29.14) compared to controls (34.86) with 12 % patients having a value of < 25 %. E/A ratio was 1.12 in patients when compared to 1.36 in controls with 32 % of patients having value < 1. Mean isovolumic relaxation time was 96.52 in patients when compared to 87.42 in controls with 24 % patients having value > 100 msec. CONCLUSIONS Normotensive diabetics are prone to left ventricular dysfunction. Diastolic dysfunction is more common than systolic dysfunction. KEYWORDS Diabetes Mellitus, Systolic Dysfunction, Diastolic Dysfunction, Cardiovascular Disease

scholarly journals Left ventricle diastolic dysfunction in diabetes: an update

2007 ◽  
Vol 51 (2) ◽  
pp. 168-175 ◽  
Author(s):  
Cláudia Maria V. Freire ◽  
Ana Luiza M.T. Moura ◽  
Márcia de Melo Barbosa ◽  
Lucas José de C. Machado ◽  
Anelise Impeliziere Nogueira ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Tissue Doppler ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Detailed Evaluation ◽  
Ventricular Diastolic Dysfunction ◽  
And Function

Diabetes mellitus, a disease that has been reaching epidemic proportions, is an important risk factor to the development of cardiovascular complication. Diabetes causes changes within the cardiac structure and function, even in the absence of atherosclerotic disease. The left ventricular diastolic dysfunction (VE) represents the earliest pre-clinical manifestation of diabetic cardiomyopathy, preceding the systolic dysfunction and being able to evolve to symptomatic heart failure. The doppler echocardiography has emerged as an important noninvasive diagnostic tool, providing reliable data in the stages of diastolic function, as well as for systolic function. With the advent of recent echocardiographic techniques, such as tissue Doppler and color M-mode, the accuracy in identifying the moderate diastolic dysfunction, the pseudonormal pattern, has significantly improved. Due to cardiometabolic repercussions of DM, a detailed evaluation of cardiovascular function in diabetic patients is important, and some alterations may be seen even in patients with gestational diabetes.

scholarly journals A STUDY TO CORRELATE HBA1C LEVELS AND LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

2016 ◽  
Vol 5 (51) ◽  
pp. 3312-3317 ◽  
Author(s):  
Vasanthi Perumal ◽  
Namitha Narayanan ◽  
Jayanthi Rangarajan ◽  
Elangumanan Palanisamy ◽  
Mohamed Kalifa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Type Ii ◽  
Newly Diagnosed ◽  
Ventricular Diastolic Dysfunction ◽  
Hba1c Levels
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