Prevalence of cardiac dysfunction in type 2 diabetes in a tertiary health care setup
Abstract
Introduction: Diabetes mellitus (DM) may be one factor that specifically influences cardiac diastolic function. The present study was designed to examine cardiac dysfunction in diabetes subjects with non-chronic renal failure (CRF).
Materials and methods: Study was approved by Institutional ethics committee, Informed consent from the study subjects. Diagnosis of diabetes was made according to WHO criteria. Plasma glucose concentration, serum lipids (total cholesterol, triglycerides, LDL cholesterol and HDL plasma cholesterol concentrations) were measured as per standard procedures. Glycosylated hemoglobin (HbA1c) was estimated by ion exchange resin method. ECG recording was obtained for every subject to rule out ischemic heart disease.
Results: Of the 150 study Type 2 diabetes participants, the male female ratio was 1.1. The mean HbA1C was 9.112±1.36 %. 2D ECHO findings showed 34% left ventricular hypertrophy and 51.3% diastolic dysfunction. Dyslipidemia was identified in 54.7% and statistically there was no significant association between dyslipidemia and diastolic dysfunction (P = 0.532).
Conclusion: In this study, diastolic dysfunction dyslipidemia was identified in 51.5% participants without dyslipedemia. Though, there was no significant difference, this number is to be considered. However, studies should be conducted with big samples size.
Downloads
References
International Diabetes Federation. IDF Diabetic Atlas 7th Edition 2019. Book.
Richard E. Gilbert, Kim Connelly, Darren J. Kelly, Carol A. Pollock, Henry Krum. Heart Failure and Nephropathy: Catastrophic and Interrelated Complications of Diabetes Clin J Am Soc Nephrol. 2006;1(2):193-208. doi: https://doi.org/10.2215/CJN.00540705.
Krum H, Gilbert RE. Demographics and concomitant disorders in heart failure. Lancet. 2003;362(9378):147-158. doi: https://doi.org/10.1016/S0140-6736(03)13869-X
Zhenhua He. Diagnosis and treatment of diabetic nephropathy in type 1 and type 2 diabetes patients. J Mol Biomark Diagn 2016;7:295. doi: https://doi.org/10.4172/2155-9929.1000295.
Pálsson R, Patel UD. Cardiovascular complications of diabetic kidney disease. Advan Chron Kid Dis. 2014;21(3):273-280. doi: https://doi.org/10.1053/j.ackd.2014.03.003.
Celentano A, Vaccaro O, Tammaro P, Galderisi M, Crivaro M, Oliviero M, et al. Early abnormalities of cardiac function in non-insulin-dependent diabetes mellitus and impaired glucose tolerance. Am J Cardiol. 1995;76 (16):1173-1176. doi: https://doi.org/10.1016/S0002-9149(99)80330-0.
Miyazato J, Horio T, Takiuchi S, Kamide K, Sasaki O, Nakamura S, Nakahama H, et al. Left ventricular diastolic dysfunction in patients with chronic renal failure: impact of diabetes mellitus. Diabet Med. 2005;22(6):730-736. doi: https://doi.org/10.1111/j.1464-5491.2005.01500.x.
Liu JE, Palmieri V, Roman MJ, Bella JN, Fabsitz R, Howard BV, et al. The impact of diabetes on left ventricular filling pattern in normotensive and hypertensive adults: the Strong Heart Study. J Am Coll Cardiol. 2001;37(7):1943-1949. doi: https://doi.org/10.1016/S0735-1097(01)01230-X.
Nagano N, Nagano M, Yo Y, Iiyama K, Higaki J, Mikami H, Ogihara T. Role of glucose intolerance in cardiac diastolic function in essential hypertension. Hyperten. 1994;23(6_pt_2):1002-1005.
Miyazato J, Horio T, Takishita S, Kawano Y. Fasting plasma glucose is an independent determinant of left ventricular diastolic dysfunction in nondiabetic patients with treated essential hypertension. Hyperten Res. 2002;25(3):403-409.
Sato A, Tarnow L, Parving HH. Prevalence of left ventricular hypertrophy in Type I diabetic patients with diabetic nephropathy. Diabetol. 1999;42(1):76-80. doi: https://doi.org/10.1007/s001250051116.
Maack C, Lehrke M, Backs J, Heinzel FR, Hulot JS5, Marx N, et al. Heart failure and diabetes: metabolic alterations and therapeutic interventions: a state-of-the-art review from the Translational Research Committee of the Heart Failure Association-European Society of Cardiology. Eur Heart J. 2018;39(48):4243-4254. doi: https://doi.org/10.1093/eurheartj/ehy596.
van Heerebeek L, Hamdani N, Handoko ML, Falcao-Pires I, Musters RJ, Kupreishvili K, et al. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulat. 2008;117(1):43-51. Epub 2007 Dec 10. doi: https://doi.org/10.1161/CIRCULATIONAHA.107.728550
Falcão-Pires I, Hamdani N, Borbély A, Gavina C, Schalkwijk CG, van der Velden J, et al. Diabetes mellitus worsens diastolic left ventricular dysfunction in aortic stenosis through altered myocardial structure and cardiomyocyte stiffness. Circulation. 2011;124(10):1151-9. doi: https://doi.org/10.1161/CIRCULATIONAHA.111.025270. Epub 2011 Aug 15.
Schannwell CM, Schneppenheim M, Perings S, Plehn G, Strauer BE. Left ventricular diastolic dysfunction as an early manifestation of diabetic cardiomyopathy. Cardiol. 2002;98(1-2):33-39. doi: https://doi.org/10.1159/000064682
Di Bonito P, Cuomo S, Moio N, Sibilio G, Sabatini D, Quattrin S, et al. Diastolic dysfunction in patients with non-insulin-dependent diabetes mellitus of short duration. Diabet Med. 1996;13 (4):321-324. doi: https://doi.org/10.1002/(SICI)1096-9136(199604)13:4%3C321::AID-DIA3%3E3.0.CO;2-7.
Levelt E, Mahmod M, Piechnik SK, Ariga R, Francis JM, Rodgers CT, et al. Relationship Between Left Ventricular Structural and Metabolic Remodeling in Type 2 Diabetes. Diab. 2016;65(1):44-52. doi: https://doi.org/10.2337/db15-0627. Epub 2015 Oct 5.
Levelt E, Pavlides M, Banerjee R, Mahmod M, Kelly C, Sellwood J, et al. Ectopic and Visceral Fat Deposition in Lean and Obese Patients with Type 2 Diabetes. J Am Coll Cardiol. 2016;68 (1):53-63. doi: https://doi.org/10.1016/j.jacc.2016.03.597.
Poantă L, Fodor D, Albu A. Left ventricular function in patients with uncomplicated well-controlled diabetes mellitus. Med Ultrason. 2010;12(3):184-187.
Serhiyenko VA, Serhiyenko AA. Cardiac autonomic neuropathy: Risk factors, diagnosis and treatment. World J Diabetes. 2018 ;9(1):1-24. doi: https://dx.doi.org/10.4239%2Fwjd.v9.i1.1.
Bhuyan AK, Baro A, Sarma D, Choudhury B. A Study of Cardiac Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus: A Northeast India Experience. Indian J Endocrinol Metab. 2019;23(2):246-250. doi: https://dx.doi.org/10.4103%2Fijem.IJEM_336_18.
Takeda Y, Sakata Y, Mano T, Ohtani T, Kamimura D, Tamaki S, et al. Competing risks of heart failure with preserved ejection fraction in diabetic patients. Eur J Heart Fail. 2011;13(6):664-669. doi: https://doi.org/10.1093/eurjhf/hfr019. Epub 2011 Mar 17.
Soldatos G, Jandeleit-Dahm K, Thomson H, Formosa M, D'orsa K, Calkin AC, et al. Large artery biomechanics and diastolic dysfunctionin patients with Type 2 diabetes. Diabet Med. 2011;28(1):54-60. doi: https://doi.org/10.1111/j.1464-5491.2010.03146.x.
Nikhil M Dikshit, Parizad Z Wadia, Deepak K Shukla. Diastolic dysfunction in diabetes mellitus. Nat J Med Res. 2013;3(3):249-252.
Kumar VS, Sreelatha M, Ramesh K, Shekar GC. Study of Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus Patients. In J Sci Study. 2017;5(4):219-224. doi: 10.17354/ijss/2017/368.
OAI - Open Archives Initiative
