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Identification of a definite diabetic cardiomyopathy in type 2 diabetes by comprehensive echocardiographic evaluation: A cross-sectional comparison with non-diabetic weight-matched controls.
J Diabetes. 2015 Nov; 7(6):779-90.JD

Abstract

BACKGROUND

Subclinical left ventricular (LV) dysfunction is prevalent in type 2 diabetes (T2DM). As obesity has been proposed as one causal factor in the disease process, this could bias the reported prevalences. We wanted to characterize echocardiographic LV dysfunction in obese T2DM subjects as compared to non-diabetic obese controls.

METHODS

One hundred patients with T2DM without clinical signs of heart failure (29% females, mean ± SD age 58.4 ± 10.5 years, body mass index (BMI) 30.1 ± 5.5 kg/m(2), blood pressure (BP) 141 ± 18/83 ± 9 mmHg) and 100 non-diabetic controls (29% females) matched for age (58.6 ± 10.5 years), BMI (29.8 ± 4.0 kg/m(2) and systolic BP (140 ± 14 mmHg) underwent echocardiography and color tissue Doppler imaging (TDI). Diastolic function was evaluated with conventional Doppler recordings and early (e') and late (a') myocardial velocities. The ratio between early transmitral filling (E) and the corresponding myocardial tissue velocity (e') served as an index of LV filling pressure.

RESULTS

T2DM patients had more concentric hypertrophy with a relative wall thickness of 0.42 ± 0.07 vs controls 0.38 ± 0.07, P < 0.001. The T2DM group had signs of diastolic dysfunction with lower E/A ratio (0.91 ± 0.27 vs. 1.12 ± 0.38, P < 0.001), deceleration time (195 ± 49 vs 242 ± 72 ms, P < 0.001), e' (5.7 ± 2.0 vs. 6.6 ± 1.8 cm/s, P = 0.001), and a' (6.5 ± 2.0 vs. 7.6 ± 1.5 cm/s, P < 0.001) compared to the controls, and higher E/e' (13.3 ± 4.7 vs. 11.1 ± 3.5, P < 0.001). Thus, there were indications of pseudo normalization and increased filling pressure in the T2DM group, whereas the controls had evidence for relaxation abnormalities without elevated filling pressure.

CONCLUSION

Compared to a non-diabetic obese group, more advanced subclinical impairment of diastolic function was seen in T2DM.

Authors+Show Affiliations

Department of Medical Research, Baerum Hospital, Vestre Viken Hospital Trust, Baerum, Norway.Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.MI Lab and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.Department of Medical Research, Baerum Hospital, Vestre Viken Hospital Trust, Baerum, Norway.Department of Endocrinology, Morbid Obesity and Preventive Disease, Oslo University Hospital Aker, Oslo, Norway. Faculty of Medicine, University of Oslo, Oslo, Norway.Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. K.G. Jebsen Cardiac Research Centre and Center for Heart Failure Research, Oslo Faculty of Medicine, University of Oslo, Oslo, Norway.Unit of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.Department of Medical Research, Baerum Hospital, Vestre Viken Hospital Trust, Baerum, Norway.MI Lab and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25350248

Citation

Ofstad, Anne Pernille, et al. "Identification of a Definite Diabetic Cardiomyopathy in Type 2 Diabetes By Comprehensive Echocardiographic Evaluation: a Cross-sectional Comparison With Non-diabetic Weight-matched Controls." Journal of Diabetes, vol. 7, no. 6, 2015, pp. 779-90.
Ofstad AP, Urheim S, Dalen H, et al. Identification of a definite diabetic cardiomyopathy in type 2 diabetes by comprehensive echocardiographic evaluation: A cross-sectional comparison with non-diabetic weight-matched controls. J Diabetes. 2015;7(6):779-90.
Ofstad, A. P., Urheim, S., Dalen, H., Orvik, E., Birkeland, K. I., Gullestad, L., W Fagerland, M., Johansen, O. E., & Aakhus, S. (2015). Identification of a definite diabetic cardiomyopathy in type 2 diabetes by comprehensive echocardiographic evaluation: A cross-sectional comparison with non-diabetic weight-matched controls. Journal of Diabetes, 7(6), 779-90. https://doi.org/10.1111/1753-0407.12239
Ofstad AP, et al. Identification of a Definite Diabetic Cardiomyopathy in Type 2 Diabetes By Comprehensive Echocardiographic Evaluation: a Cross-sectional Comparison With Non-diabetic Weight-matched Controls. J Diabetes. 2015;7(6):779-90. PubMed PMID: 25350248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identification of a definite diabetic cardiomyopathy in type 2 diabetes by comprehensive echocardiographic evaluation: A cross-sectional comparison with non-diabetic weight-matched controls. AU - Ofstad,Anne Pernille, AU - Urheim,Stig, AU - Dalen,Håvard, AU - Orvik,Elsa, AU - Birkeland,Kåre I, AU - Gullestad,Lars, AU - W Fagerland,Morten, AU - Johansen,Odd Erik, AU - Aakhus,Svend, Y1 - 2015/01/15/ PY - 2014/02/28/received PY - 2014/09/11/revised PY - 2014/10/07/accepted PY - 2014/10/29/entrez PY - 2014/10/29/pubmed PY - 2016/8/4/medline KW - diabetic cardiomyopathy KW - echocardiography KW - left ventricular dysfunction KW - obesity KW - type 2 diabetes mellitus KW - 关键词:糖尿病性心肌病,超声心动图,左心室功能不全,肥胖,2型糖尿病 SP - 779 EP - 90 JF - Journal of diabetes JO - J Diabetes VL - 7 IS - 6 N2 - BACKGROUND: Subclinical left ventricular (LV) dysfunction is prevalent in type 2 diabetes (T2DM). As obesity has been proposed as one causal factor in the disease process, this could bias the reported prevalences. We wanted to characterize echocardiographic LV dysfunction in obese T2DM subjects as compared to non-diabetic obese controls. METHODS: One hundred patients with T2DM without clinical signs of heart failure (29% females, mean ± SD age 58.4 ± 10.5 years, body mass index (BMI) 30.1 ± 5.5 kg/m(2), blood pressure (BP) 141 ± 18/83 ± 9 mmHg) and 100 non-diabetic controls (29% females) matched for age (58.6 ± 10.5 years), BMI (29.8 ± 4.0 kg/m(2) and systolic BP (140 ± 14 mmHg) underwent echocardiography and color tissue Doppler imaging (TDI). Diastolic function was evaluated with conventional Doppler recordings and early (e') and late (a') myocardial velocities. The ratio between early transmitral filling (E) and the corresponding myocardial tissue velocity (e') served as an index of LV filling pressure. RESULTS: T2DM patients had more concentric hypertrophy with a relative wall thickness of 0.42 ± 0.07 vs controls 0.38 ± 0.07, P < 0.001. The T2DM group had signs of diastolic dysfunction with lower E/A ratio (0.91 ± 0.27 vs. 1.12 ± 0.38, P < 0.001), deceleration time (195 ± 49 vs 242 ± 72 ms, P < 0.001), e' (5.7 ± 2.0 vs. 6.6 ± 1.8 cm/s, P = 0.001), and a' (6.5 ± 2.0 vs. 7.6 ± 1.5 cm/s, P < 0.001) compared to the controls, and higher E/e' (13.3 ± 4.7 vs. 11.1 ± 3.5, P < 0.001). Thus, there were indications of pseudo normalization and increased filling pressure in the T2DM group, whereas the controls had evidence for relaxation abnormalities without elevated filling pressure. CONCLUSION: Compared to a non-diabetic obese group, more advanced subclinical impairment of diastolic function was seen in T2DM. SN - 1753-0407 UR - https://www.unboundmedicine.com/medline/citation/25350248/Identification_of_a_definite_diabetic_cardiomyopathy_in_type_2_diabetes_by_comprehensive_echocardiographic_evaluation:_A_cross_sectional_comparison_with_non_diabetic_weight_matched_controls_ L2 - https://doi.org/10.1111/1753-0407.12239 DB - PRIME DP - Unbound Medicine ER -