Echocardiographic evaluation of diastolic dysfunction in diabetes mellitus without covert cardiac involvement

Nalin Kumar Mahesh; Anil Kumar; Niket Verma; Keshavamurthy Ganapathy Bhat; Dharmender Kumar

doi:10.18203/2349-3933.ijam20180941

Authors

Nalin Kumar Mahesh Department of Medicine and Cardiology, Army College of Medical Sciences and Base Hospital, New Delhi, India
Anil Kumar Department of Cardiology, Command Hospital Chandimandir, Panchkula, Haryana, India
Niket Verma Department of Medicine, Army College of Medical Sciences, New Delhi, India
Keshavamurthy Ganapathy Bhat Department of Medicine, Army College of Medical Sciences, New Delhi, India
Dharmender Kumar Department of Medicine, Army College of Medical Sciences, New Delhi, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20180941

Keywords:

Diabetes mellitus, Diastolic dysfunction

Abstract

Background: Diabetic patients develop systolic and diastolic dysfunction without even associated coronary artery disease. But diastolic dysfunction is more prevalent in diabetic patients than systolic dysfunction and usually occurs before onset of symptoms. Recognition of early diastolic dysfunction is likely to make management better and avoids progression of cardiac dysfunction. This study was conducted in patients of Diabetes mellitus without other comorbidities.

Methods: The present study which is cross sectional and was carried out among outpatients and inpatients of tertiary care hospital of Armed forces and involved army personnel and their dependents and sample size was 100 patients.

Results: The prevalence of diastolic dysfunction among our study participants was found to be 36%. Diastolic dysfunction was found to be significantly higher among elderly individuals (60%) when compared to young study participants. (p<0.0001). Prevalence of diastolic dysfunction was found to be non-significantly higher among males and with longer duration of diabetes as compared to lesser duration and female gender.

Conclusions: Diastolic dysfunction, evaluated by echocardiography, was found to be fairly prevalent (36%; 95% CI = 27-45%) among individuals with type 2 diabetes mellitus. Poor Glycaemic control and increasing age were found to be significantly associated with presence of diastolic dysfunction among individuals with diabetes mellitus.

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References

Collaboration ERF. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215-22.

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. Plos Med. 2006;3(11):e442.

Howard BV, Rodriguez BL, Bennett PH, Harris MI, Hamman R, Kuller LH, et al. Prevention Conference VI: Diabetes and Cardiovascular Disease Writing Group I: Epidemiology. Circulation. 2002;105(18):e132-e7.

Vinereanu D, Nicolaides E, Tweddel AC, Madler CK, Holst B, Boden LE, et al. Subclinical left ventricular dysfunction in asymptomatic patients with Type II diabetes mellitus, related to serum lipids and glycated haemoglobin. Clinical Sci. 2003;105(5):591-9.

Bertoni AG, Tsai A, Kasper EK, Brancati FL. Diabetes and Idiopathic Cardiomyopathy A nationwide case-control study. Diabetes care. 2003;26(10):2791-5.

Fang ZY, Schull-Meade R, Leano R, Mottram PM, Prins JB, Marwick TH. Screening for heart disease in diabetic subjects. American heart J. 2005;149(2):349-54.

Poirier P, Bogaty P, Garneau C, Marois L, Dumesnil JG. Diastolic Dysfunction in Normotensive Men with Well-Controlled Type 2 Diabetes Importance of maneuvers in echocardiographic screening for preclinical diabetic cardiomyopathy. Diabetes care. 2001;24(1):5-10.

Liu JE, Robbins DC, Palmieri V, Bella JN, Roman MJ, Fabsitz R, et al. Association of albuminuria with systolic and diastolic left ventricular dysfunction in type 2 diabetes: the Strong Heart Study. J Ame Coll Cardiol. 2003;41(11):2022-8.

Zabalgoitia M, Ismaeil MF, Anderson L, Maklady FA. Prevalence of diastolic dysfunction in normotensive, asymptomatic patients with well-controlled type 2 diabetes mellitus. American J Cardiol. 2001;87(3):320-3.

Boyer JK, Thanigaraj S, Schechtman KB, Pérez JE. Prevalence of ventricular diastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus. American J Cardiol. 2004;93(7):870-5.

Valle R, Bagolin E, Canali C, Giovinazzo P, Barro S, Aspromonte N, et al. The BNP assay does not identify mild left ventricular diastolic dysfunction in asymptomatic diabetic patients. European Heart J-Cardiovascular Imaging. 2006;7(1):40-4.

Nishimura RA, Abel MD, Hatle LK, Tajik AJ. Assessment of diastolic function of the heart: background and current applications of Doppler echocardiography. Part II. Clinical studies. Mayo Clinic Proceedings; Elsevier;1989:181-204.

Cohen GI, Pietrolungo JF, Thomas JD, Klein AL. A practical guide to assessment of ventricular diastolic function using Doppler echocardiography. J American Coll Cardiology. 1996;27(7):1753-60.

Senthil N, Vengadakrishnan K, Vankineni SS, Sujatha S. Diastolic Dysfunction in Young Asymptomatic Diabetics Patients. Int J Sci Stud. 2015;3(7):226-9.

Chaudhary AK, Aneja GK, Shukla S, Razi SM. Study on diastolic dysfunction in newly diagnosed type 2 diabetes mellitus and its correlation with glycosylated haemoglobin (HbA1c). J Clinical Diagnostic Res. JCDR. 2015;9(8):OC20.

Madhumathi R, Gowdaiah PK, Dudhwewala A, Chaithra A, Dande T. Echocardiographic evaluation of diastolic dysfunction in asymptomatic type 2 diabetes mellitus patients. Diabetes. 2014;89.

Patil VC, Shah KB, Vasani JD, Shetty P, Patil HV. Diastolic dysfunction in asymptomatic type 2 diabetes mellitus with normal systolic function. J Cardiovascular Dis Res. 2011;2(4):213-22.

Chandravanshi S, Jain A, Gupta S. Echocardiographic evaluation of diastolic dysfunction in asymptomatic type 2 diabetes mellitus. J Evolution Med Dent Sci. 2015;4(63):10974-84.