Left ventricular diastolic dysfunction in Type 1 Diabetes Mellitus: The potential nexus

2021 ◽  
Vol 13 (02) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Diastolic Dysfunction ◽  
Type 1 Diabetes Mellitus ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Diastolic Dysfunction

scholarly journals Echocardiographic evaluation of left ventricular diastolic dysfunction in recently diagnosed type 2 diabetes mellitus

2018 ◽  
Vol 6 (5) ◽  
pp. 1691
Author(s):  
Swapnil Jain ◽  
C. L. Nawal ◽  
Amandeep Singh ◽  
Radhey Shyam Chejara ◽  
Sagar Barasara ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
P Value ◽  
Diabetic Patients ◽  
Ventricular Diastolic Dysfunction

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

P620The prognostic value of the ratio of transmitral early filling velocity to early diastolic strain rate in type 1 diabetes patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M H Lassen ◽  
T B S Biering-Soerensen ◽  
P G J Joergensen ◽  
H U A Andersen ◽  
P R Rossing ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Morbidity And Mortality ◽  
Female Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Early Filling

Abstract Background Cardiovascular disease is one of the main causes of morbidity and mortality in patients suffering from type 1 diabetes mellitus. It is of great importance to identify early signs of cardiac pathology such as elevated left ventricular (LV) filling pressure. The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has in recent studies proved to be an accurate measure of left ventricular (LV) filling pressure. Furthermore, E/e'sr has demonstrated strong prognostic value across different study populations. Purpose The aim of this study was to assess the prognostic value of E/e'sr in a large cohort of patients with type 1 diabetes mellitus in relation to cardiovascular morbidity and mortality. Methods In this prospective study, 1082 patients with type 1 diabetes mellitus (mean age 50±15 years, 53% male, mean duration of diabetes 26 years) underwent a comprehensive echocardiographic examination including both conventional measurements and two-dimensional speckle tracking in which E/e'sr along with other echocardiographic measurements were obtained. The primary outcome was defined as a major cardiac event (heart failure, stroke, myocardial infarction or cardiovascular death). Results During follow-up (median: 6.2 years, IQR: 5.7, 6.9) 144 (13.3%) met the composite outcome. E/e'sr was significantly associated with the composite outcome (E/e'sr: HR 1.36 95% CI [1.25–1.47], p<0.001, per 0.10m increase) (figure). E/e'sr remained an independent predictor after multivariable adjustment for age, gender, duration of diabetes, BMI, HbA1c, smoking status, level of physical activity, systolic blood pressure, cholesterol level, eGFR, albuminuria, LV ejection fraction, LV dimensions and left atrial volume index (E/e'sr: HR 1.16 95% CI [1.04–1.28], p=0.006, per 0.10m increase). Interestingly, E/e'sr was especially good as a prognosticator in female patients (p for interaction = 0.008) in a univariable model: (female: HR 1.53 95% CI [1.37–1.71], p<0.001, per 0.10m increase) (male: HR 1.23 95% CI [1.10–1.38], p<0.001, per 0.10m increase). In the same multivariable model as before, E/e'sr remained an independent predictor of the outcome in female patients whereas the same was not true for male patients (female: HR 1.39 95% CI [1.18–1.66], p<0.001, per 0.10m increase) vs (male: HR 1.05 95% CI [0.92–1.21], p=0.46, per 0.10m increase). Conclusion In patients with type 1 diabetes, E/e'sr provides independent prognostic information regarding cardiovascular morbidity and mortality. Furthermore, E/e'sr seems to have stronger prognostic value in female patients with type 1 diabetes.

Sign in / Sign up

Export Citation Format

Share Document