scholarly journals Prevalence and Predictors of Left Ventricular Diastolic Dysfunction in Malaysian Patients With Type 2 Diabetes Mellitus Without Prior Known Cardiovascular Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Kok Han Chee ◽  
Kok Leng Tan ◽  
Ibrahim Luqman ◽  
Shahrizal Shudim Saiful ◽  
Yee Yean Chew ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Diastolic Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Chinese Ethnicity ◽  
Ventricular Diastolic Dysfunction ◽  
Echocardiographic Assessment

Objective: Existing data showed that left ventricular diastolic dysfunction is common in individuals with type 2 diabetes mellitus (T2DM). However, most of the studies included diabetic patients who have prior cardiovascular disease, which might be the compounding factor for ventricular dysfunction. This study aimed to determine the prevalence and predictors of left ventricular diastolic dysfunction in an Asian population with T2DM without prior cardiovascular disease using the latest recommended echocardiographic assessment for left ventricular diastolic dysfunction.Design and Participants: This is a cross-sectional study in which eligible patients with T2DM without history of coronary artery disease, heart failure, or valvular heart disease were recruited. Demographic data, diabetic control, comorbidities, microvascular/macrovascular complications, and medications prescribed were recorded. Venous blood was sent to test for B-type natriuretic peptide, and transthoracic echocardiography was performed to assess left ventricular dysfunction.Setting: This study was performed in a tertiary healthcare center located in Kuala Lumpur, Malaysia.Results: Of the 301 patients, 83.1% have had T2DM for >10 years, with 45.8% being poorly controlled. Comorbidities include hypertension (77.1%), hyperlipidemia (91.0%), and pre-obesity/obesity (72.9%). Majority had absence of microvascular (albuminuria, retinopathy, and neuropathy) and macrovascular (peripheral vascular disease and stroke) complications. None had raised B-type natriuretic peptide levels, and 93.7% had no symptoms of heart failure. On echocardiographic assessment, 70.1% had left ventricular diastolic dysfunction, and 90.5% had Grade 1/mild severity. Age, ethnicity, insulin therapy, presence of hypertension, and hyperlipidemia were significantly associated with left ventricular diastolic dysfunction. Older T2DM patients of Chinese ethnicity and on insulin are about two times more likely to develop left ventricular diastolic dysfunction.Conclusion: There was a high prevalence of asymptomatic left ventricular diastolic dysfunction among patients with T2DM without prior known cardiovascular disease. Older age, insulin therapy, and Chinese ethnicity were risk factors for left ventricular diastolic dysfunction in T2DM.

scholarly journals Left ventricular diastolic dysfunction in asymptomatic type 2 diabetes mellitus patients

2017 ◽  
Vol 6 (1) ◽  
pp. 240
Author(s):  
Karan Jain ◽  
Amit A. Palange ◽  
Arjun Lal Kakrani ◽  
Akshay S. Dhanorkar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Muscle Disease ◽  
Ventricular Diastolic Dysfunction

Background: Diastolic dysfunction has been described as an early sign of diabetic heart muscle disease preceding the systolic damage. The pathogenesis of ventricular dysfunction remains unknown and has been somewhat controversial. So far, very few population-based studies have been carried out in India, to demonstrate the prevalence of diastolic dysfunction in diabetic subjects. Hence the present study was done at our tertiary care centre to detect left diastolic dysfunction in asymptomatic type 2 diabetes individuals and to use echo-cardiologic assessment as an early detector of left diastolic dysfunction. The aim of this study was to detect left diastolic dysfunction in asymptomatic type 2 diabetes individuals and to use echocardiologic assessment as an early detector of left diastolic dysfunction.Methods: A hospital based cross-sectional observational study was conducted with 50 patients for echocardiographic evaluation of diastolic dysfunction in asymptomatic Type 2 Diabetes Mellitus. E/A <1 and increase in LA size was considered as the evidence of left ventricular Diastolic Dysfunction.Results: 15 (30%) patients were detected with Left Ventricular Diastolic Dysfunction (LVDD) among the 50 patients under study.Conclusions: Diastolic dysfunction in patients with diabetes is present in 30% of patients even when diabetes is present at a younger age, and is of a shorter duration. This dysfunction is suggestive of pre-clinical diabetic cardiomyopathy. E/A, DT and peak A velocity are sensitive indices of diastolic LV dysfunction. Thus, diastolic dysfunction can be used as an early indicator, as it is a precursor to increased LV hypertrophy and clinical left ventricular 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

scholarly journals Glycosylated hemoglobin and left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus

2017 ◽  
Vol 5 (12) ◽  
pp. 5330 ◽  
Author(s):  
Vishal S. Yesankar ◽  
Nalini R. Humaney
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Glycosylated Hemoglobin ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Type I ◽  
Type Ii ◽  
Chi Square ◽  
Ventricular Diastolic Dysfunction

Background: Diabetes mellitus is one of the most common diseases. Left ventricular diastolic dysfunction may represent the early stage of diabetic cardiomyopathy thus reinforcing the importance of the early examination of diastolic function in individuals with diabetes.Methods: This is a hospital based cross-sectional study done at a tertiary care hospital catering mainly to rural population. Patients having type 2 diabetes mellitus were scrutinized for doppler echocardiography and HbA1c levels. As per the previous studies and considering the prevalence of asymptomatic diastolic dysfunction in diabetics, the sample size was calculated. Statistical analysis was done by using descriptive and inferential statistics using chi square test.Results: In the present study 45 patients had HbA1C between 6.5- 8.0, out of which 9 had type I diastolic dysfunction, 1 had type II diastolic dysfunction and 35 had no diastolic dysfunction. 16 patients had HbA1C between 8.1- 9.5, out of which 7 had type I diastolic dysfunction, 8 had type II diastolic dysfunction and 1 had no diastolic dysfunction. 14 patients had HbA1C more than 9.5, out of which 4 had type I diastolic dysfunction, 5 had type II diastolic dysfunction, 4 had type III diastolic dysfunction and 1 patient did not had any diastolic dysfunction. The Chi-Square value is 55.51 and p value is 0.000 (Significant).Conclusions: Diastolic dysfunction correlates with the levels of glycosylated hemoglobin, duration of diabetes mellitus, presence of microvascular complications like diabetic retinopathy, neuropathy and nephropathy.

scholarly journals Left ventricular diastolic dysfunction in normotensive postmenopausal women with type 2 diabetes mellitus

2017 ◽  
Vol 24 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Maria Maiello ◽  
Annapaola Zito ◽  
Annagrazia Cecere ◽  
Marco Matteo Ciccone ◽  
Pasquale Palmiero
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Postmenopausal Women ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Diastolic Dysfunction
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