scholarly journals Effect On Cardiac Function Among Patients With Type 2 Diabetes Following High-Dose Mineralocorticoid Receptor Antagonist Using Echocardiography; Data From The MIRAD Randomized Clinical Trial

2021 ◽  
Author(s):  
Niels H. Brandt-Jacobsen ◽  
Marie Louise Johansen ◽  
Jon Rasmussen ◽  
Morten Dalsgaard ◽  
Thomas Kumler ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
High Risk ◽  
Cardiac Function ◽  
Diastolic Function ◽  
Mineralocorticoid Receptor ◽  
Left Ventricular ◽  
High Dose ◽  
High Risk Type

Abstract Background: Early heart failure (HF)-prevention is central in patients with type 2 diabetes, and mineralocorticoid receptor antagonists (MRAs) have shown to improve prognosis. We investigated the effect of high-dose MRA, eplerenone, on cardiac function and structure in patients with type 2 diabetes and established or increased risk of cardiovascular disease but without HF. Methods: In the current randomized, placebo-controlled clinical trial, 140 patients with high-risk type 2 diabetes were randomized to high-dose eplerenone (100-200 mg daily) or placebo as add-on to standard care for 26 weeks. Left ventricular (LV) systolic and diastolic function, indexed LV mass (LVMi), and global longitudinal strain (GLS) were assessed using echocardiography at baseline and after 26 weeks of treatment. Results: Of the included patients, 138 (99%) had an echocardiography performed at least once. Baseline early diastolic in-flow velocity (E-wave) indexed by mitral annulus velocity (e’) was mean (SD) 11.1 (0.5), with 31% of patients reaching above 12. No effect of treatment on diastolic function was observed measured by E/e’ (0.0, 95%CI [-1.2 to 1.2], P=0.992) or E/A (-0.1, 95%CI [-0.2 to 0.0], P=0.191). Mean LV ejection fraction (LVEF) at baseline was 59.0% (8.0). No improvement in systolic function was observed when comparing groups after 26 weeks (LVEF: 0.9, 95%CI [-1.1 to 2.8], P=0.382; GLS: -0.4%, 95%CI [-1.5 to 0.6], P=0.422), nor in LVMi (-3.8 g/m2 95%CI [-10.2 to 2.7], P=0.246). Conclusion: In the present echo sub-study, no change in cardiac function was observed following high-dose MRA therapy in patients with high-risk type 2 diabetes.Trial registration: Date of registration 25/08/2015 (EudraCT number: 2015-002519-14)

Effects of Oral Amino Acid Supplements on Cardiac Function and Remodeling in Patients with Type 2 Diabetes with Mild-to-Moderate Left Ventricular Dysfunction

2008 ◽  
Vol 101 (11) ◽  
pp. S111-S115 ◽  
Author(s):  
Roldano Scognamiglio ◽  
Christian Negut ◽  
Monica Palisi ◽  
Francesco S. Dioguardi ◽  
Micol Coccato ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Amino Acid ◽  
Cardiac Function ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular

Sex-specific pattern of left ventricular hypertrophy and diastolic function in patients with type 2 diabetes mellitus

2020 ◽  
Author(s):  
Mei-Zhen Wu ◽  
Yan Chen ◽  
Yu-Juan Yu ◽  
Zhe Zhen ◽  
Ying-Xian Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Cardiovascular Death ◽  
Left Ventricular ◽  
Specific Pattern

Abstract Aims  Few prospective studies have evaluated sex-specific pattern, natural progression of left ventricular (LV) remodelling, and diastolic dysfunction in patients with type 2 diabetes (T2DM). The aim of this study was to study the sex-specific prevalence, longitudinal changes of LV remodelling, and diastolic dysfunction in patients with T2DM. Further, the prognostic value of diastolic function in women and men was also evaluated. Methods and results  A total of 350 patients with T2DM (mean age 61 ± 11 years; women, 48.3%) was recruited. Detailed echocardiography was performed at baseline and after 25 months. A major adverse cardiovascular event (MACE) was defined as cardiovascular death, heart failure hospitalization, or myocardial infarction. Despite a similar age, prevalence of hypertension and body mass index, women had a higher prevalence of LV hypertrophy and diastolic dysfunction at baseline and follow-up compared with men. A total of 21 patients developed MACE (5 cardiovascular death, 9 hospitalization for heart failure, and 7 myocardial infarction) during a median follow-up of 56 months. Women with diastolic dysfunction had a higher incidence of MACE than those with normal diastolic function but this association was neutral in men. Multivariable Cox-regression analysis indicated that diastolic dysfunction was associated with MACE in women [hazard ratio = 6.30; 95% confidence interval (CI) = 1.06–37.54; P < 0.05] but not men (hazard ratio = 2.29, 95% CI = 0.67–7.89; P = 0.19). Conclusion  LV hypertrophy and diastolic dysfunction, both at baseline and follow-up, were more common in women than men. Pre-clinical diastolic dysfunction was independently associated with MACE only in women with T2DM but was neutral in men.

scholarly journals Cardiac Function in Uncomplicated Type 2 Diabetes Mellitus

2019 ◽  
Vol 18 (2) ◽  
pp. 211-215
Author(s):  
Bimal K Agrawal ◽  
Parul Jain ◽  
Saurabh Marwaha ◽  
Richa Goel ◽  
Himanshu D Kumar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiac Function ◽  
Cardiac Dysfunction ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Coronary Arterial Disease ◽  
Type 2 Dm

Objective: Diabetic cardiomyopathy (DC) is a myocardial disease characterized by myocyte hypertrophy, interstitial fibrosis, protein glycosylation and intra-myocardial micro-angiopathy due to prolonged exposure of myocardial tissues to hyperglycemia in diabetes mellitus (DM) patients. Alteration in cardiac function can be non-invasively assessed via echocardiography. The early recognition of cardiac dysfunction can prevent the symptomatic heart failure in DM patients. The study aimed at evaluating cardiac function in uncomplicated type 2 diabetes mellitus. Materials And Methods: Sixty Type 2 DM patients without any feature of the coronary arterial disease (CAD), hypertension, nephropathy and respiratory illness were enrolled in the study and compared with the sixty age matched healthy controls. Echocardiographic assessment was done in all subjects to evaluate the cardiac function. Results: Diastolic dysfunction was more common in diabetic patients when compared with normal healthy population. Systolic dysfunction progresses with age of the diabetic patient. Conclusion: Echocardiography is a simple noninvasive cost effective test for detecting cardiac dysfunction in Type 2 DM patients and should be applied to detect early Left ventricular(LV) dysfunction so that corrective measures may be initiated early and cardiac functions may be preserved for long. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.211-215

Reducing inpatient hypoglycemia in the general wards using real-time CGM- the Glucose Telemetry system: A randomized clinical trial

2020 ◽  
Author(s):  
Lakshmi G. Singh ◽  
Medha Satyarengga ◽  
Isabel Marcano ◽  
William H. Scott ◽  
Lillian F. Pinault ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
High Risk ◽  
Randomized Clinical Trial ◽  
Real Time ◽  
Lower Percentage ◽  
Telemetry System ◽  
Glucose Testing ◽  
General Wards

OBJECTIVE: Use of real-time continuous glucose monitoring (RT-CGM) systems in the inpatient setting is considered investigational. The objective of this study was to evaluate whether RT-CGM, using the glucose telemetry system (GTS), can prevent hypoglycemia in the general wards. <p>RESEARCH DESIGN AND METHODS: In a randomized clinical trial, insulin-treated patients at high risk for hypoglycemia with type 2 diabetes were recruited. Participants were randomized to RT-CGM/GTS or point of care (POC) blood glucose testing. The primary outcome was difference in inpatient hypoglycemia.</p> <p>RESULTS: Seventy-two participants were included in this interim analysis, 36 in the RT-CGM/GTS group and 36 in the POC group. RT-CGM/GTS group experienced fewer hypoglycemic events (<70 mg/dL) per patient (0.67 events per patient, 95% CI 0.34-1.30 versus 1.69 events per patient, 95% CI 1.11-2.58, <i>p</i>=0.024) and fewer clinically significant hypoglycemic events (<54 mg/dL) per patient (0.08 events per patient, 95% CI 0.03-0.26 versus 0.75, 95% CI 0.51-1.09, <i>p</i>=0.003). RT-CGM/GTS had lower percentage of time spent below range <70 mg/dl (0.40%, 95% CI 0.18%-0.92% versus 1.88%, 95% CI 1.26%-2.81%, <i>p</i>=0.002) and <54 mg/dL (0.05%, 95% CI 0.01%-0.43% versus 0.82%, 95% CI 0.47%-1.43%, <i>p</i>=0.017) compared to POC group. No differences in nocturnal hypoglycemia, time in range 70-180 mg/dL, time above range >180-250 mg/dL and >250 mg/dL were found between the groups. RT-CGM/GTS group had no prolonged hypoglycemia compared to 0.20 episodes <54mg/dL and 0.40 episodes <70mg/dL per patient in the POC group. </p> <p>CONCLUSIONS: RT-CGM/GTS can decrease hypoglycemia among hospitalized high risk insulin treated patients with type 2 diabetes.</p>

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