SAT-621 Framingham Cardiovascular Disease 10-Year-Risk Score Is Associated with Myocardial Perfusion in Asymptomatic Diabetic Patients

Abstract Background: Even without atherosclerosis, diabetes increases the risk of death from coronary heart disease and heart failure. Myocardial perfusion dysfunction may occur in the early stage of diabetic cardiomyopathy, but its examination method is relatively complex. It is very important to carry out targeted cardiac screening to find the factors related to diabetic myocardial perfusion in the early stage. Methods: We enrolled 77 patients with diabetes and 30 controls, performed anthropometric and laboratory tests such as blood glucose and lipids, and calculated Framingham Cardiovascular Disease 10-year-risk Score (FRS). All participants underwent cardiac magnetic resonance examinations and recorded their cardiac structure, functional indicators (such as ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume(SV), peak filling rate (PFR),myocardial perfusion index (maximum upslope (Slope), half time to maximum signal intensity (Time50Max (s)), time to maximum signal intensity (TimeMax (s)), the maximum signal intensity (MaxSI),, basic signal intensity (Baseline),the ratio of MaxSI and Baseline ((MaxSI (BL) %), the difference value between MaxSI and Baseline (MaxSI (BL))). Results: Compared with normal group, no cardiovascular symptoms of left ventricular and right ventricular systolic function in patients with diabetes and end-diastolic and end systolic volume had no obvious difference, left ventricular PFR is lower than normal (279.65 + 57.62 vs. 322.57 + / - 78.29, p = 0.02), in the subgroup analysis we found that the FRS high-risk groups, ventricular septal thickening tend to, and Slope, MaxSI, MaxSI BL (%), MaxSI (BL) were significantly lower than the high risk group, Time50Max and TimeMax were significantly longer than the non-high-risk group, and FRS was negatively correlated with Slope, MaxSI(%BL) and positively correlated with TimeMax(s) and Time50Max(s), with statistical significance. Conclusion: Systolic function remains and diastolic function decreases in asymptomatic diabetic patients. Moreover, the patients with high risk of FRS had significant decreased perfusion function, and the quantitative indexes of perfusion function were closely related to FRS. It is of great value to pay attention to the changes of FRS score for early screening and diagnosis of diabetic heart disease.

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Effects of Trimetazidine on Myocardial Perfusion and Left Ventricular Systolic Function in Type 2 Diabetic Patients With Ischemic Cardiomyopathy

Journal of Cardiovascular Pharmacology ◽

10.1097/fjc.0b013e31817bdd66 ◽

2008 ◽

Vol 51 (6) ◽

pp. 611-615 ◽

Cited By ~ 28

Author(s):

Romualdo Belardinelli ◽

Giovanni Cianci ◽

Mirko Gigli ◽

Marco Mazzanti ◽

Francesca Lacalaprice

Keyword(s):

Myocardial Perfusion ◽

Ischemic Cardiomyopathy ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Diabetic Patients ◽

Ventricular Systolic Function ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

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Echocardiography and EuroSCORE II for the stratification of low-gradient severe aortic stenosis and preserved left ventricular ejection fraction

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-021-02373-2 ◽

2021 ◽

Author(s):

Yan Fan ◽

Hong Shen ◽

Brandon Stacey ◽

David Zhao ◽

Robert J. Applegate ◽

...

Keyword(s):

High Risk ◽

Left Ventricular Ejection Fraction ◽

Risk Group ◽

Severe Aortic Stenosis ◽

Left Ventricular ◽

High Risk Group ◽

Low Risk ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Risk Patients

AbstractThe purpose of this study was to explore the utility of echocardiography and the EuroSCORE II in stratifying patients with low-gradient severe aortic stenosis (LG SAS) and preserved left ventricular ejection fraction (LVEF ≥ 50%) with or without aortic valve intervention (AVI). The study included 323 patients with LG SAS (aortic valve area ≤ 1.0 cm2 and mean pressure gradient < 40 mmHg). Patients were divided into two groups: a high-risk group (EuroSCORE II ≥ 4%, n = 115) and a low-risk group (EuroSCORE II < 4%, n = 208). Echocardiographic and clinical characteristics were analyzed. All-cause mortality was used as a clinical outcome during mean follow-up of 2 ± 1.3 years. Two-year cumulative survival was significantly lower in the high-risk group than the low-risk patients (62.3% vs. 81.7%, p = 0.001). AVI tended to reduce mortality in the high-risk patients (70% vs. 59%; p = 0.065). It did not significantly reduce mortality in the low-risk patients (82.8% with AVI vs. 81.2%, p = 0.68). Multivariable analysis identified heart failure, renal dysfunction and stroke volume index (SVi) as independent predictors for mortality. The study suggested that individualization of AVI based on risk stratification could be considered in a patient with LG SAS and preserved LVEF.

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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 ◽

10.1161/hyp.70.suppl_1.p355 ◽

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.

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Ophthalmic treatment of diabetic retinopathy

Diabetic Retinopathy: Screening to Treatment (Oxford Diabetes Library) ◽

10.1093/med/9780198834458.003.0019 ◽

2020 ◽

pp. 171-178

Author(s):

Ramesh R. Sivaraj ◽

Jonathan M. Gibson

Keyword(s):

Diabetic Retinopathy ◽

High Risk ◽

Group Intervention ◽

Laser Photocoagulation ◽

Interdisciplinary Approach ◽

High Risk Group ◽

Diabetic Patients ◽

Diabetic Maculopathy ◽

Operative Assessment ◽

Ophthalmic Treatment

The ophthalmic treatment of diabetic retinopathy is aimed at preserving vision and requires an interdisciplinary approach. The main treatments used for proliferative retinopathy and diabetic maculopathy include laser photocoagulation, intra-vitreal, and peri-ocular drug injections, or a combination of both. In advanced cases of diabetic retinopathy (DR), vitrectomy and retinal surgery may help preserve vision. Cataract surgery in diabetic patients is extremely successful, but overall these patients are usually considered to be at risk of more complications than the general population. Those patients with pre-existing DR at the time of surgery should be regarded as a high risk group and will require careful pre-operative assessment and post-operative review. In this group, intervention with laser photocoagulation and intra-vitreal pharmacotherapy may be necessary.

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P1291 Are we ready for machine learning in HCM risk stratification?

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.736 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

D M Adamczak ◽

M Bednarski ◽

A Rogala ◽

M Antoniak ◽

T Kiebalo ◽

...

Keyword(s):

Machine Learning ◽

High Risk ◽

Risk Group ◽

Ventricular Myocardium ◽

Left Ventricular ◽

High Risk Group ◽

Machine Learning Algorithms ◽

Left Ventricular Myocardium ◽

Risk Calculator ◽

Icd Implantation

Abstract BACKGROUND Hypertrophic cardiomyopathy (HCM) is a heart disease characterized by hypertrophy of the left ventricular myocardium. The disease is the most common cause of sudden cardiac death (SCD) in young people and competitive athletes due to fatal ventricular arrhythmias, but in most patients, however, HCM has a benign course. Therefore, it is of the utmost importance to properly evaluate patients and identify those who would benefit from a cardioverter-defibrillator (ICD) implantation. The HCM SCD-Risk Calculator is a useful tool for estimating the 5-year risk of SCD. Parameters included in the model at evaluation are: age, maximum left ventricular wall thickness, left atrial dimension, maximum gradient in left ventricular outflow tract, family history of SCD, non-sustained ventricular tachycardia and unexplained syncope. Patients’ risk of SCD is classified as low (<4%), intermediate (4-<6%) or high (≥6%). Those in the high-risk group should have an ICD implantation. It can also be considered in the intermediate-risk group. However, the calculator still needs improvement and machine learning (ML) has the potential to fulfill this task. ML algorithm creates a model for solving a specific problem without explicit programming - instead it relies only on available data - by discovering patterns and relations. METHODS 252 HCM patients (aged 20-88 years, 49,6% were men) treated in our Department from 2005 to 2018, have been enrolled. The follow-up lasted 0-13 years (average: 3.8 years). SCD was defined as sudden cardiac arrest (SCA) or an appropriate ICD intervention. All parameters from HCM SCD-Risk Calculator have been obtained and the risk of SCD has been calculated for all patients during the first echocardiographic evaluation. ML model with variables from HCM SCD-Risk Calculator has been created. Both methods have been compared. RESULTS 20 patients reached an SCD end-point. 1 patient died due to SCA and 19 had an appropriate ICD intervention. Among them, there were respectively 6, 7 and 7 patients in the low, intermediate and high-risk group of SCD. 1 patient, who died, had a low risk. The ML model correctly assessed the SCD event only in 1 patient. According to ML, the risk of SCD ≤2.07% was a negative predictor. CONCLUSIONS The study did not show an advantage of ML over HCM SCD-Risk Calculator. Because of the characteristic of the dataset (approximately the same number of features and observations), the selection of machine learning algorithms was limited. Best results (evaluated using LOOCV) were achieved with a decision tree. We expect that bigger dataset would allow improving model performance because of strong regularization need in the current setup.

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

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.137 ◽

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 <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 <0.0001), age of diabetes> 10 years (p <0.0001), glycemic imbalance with HbA1c> 7% (p <0) , 0001) and elevated fasting glucose levels (p = 0.039), obesity (p <0.0001), dyslipidemia (p <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.

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