Key result
Normotensive T2D is linked to a ~111% higher prevalence of abnormal LV diastolic filling.
Why the study?
Diabetes impairs left ventricular function independently of CAD and hypertension, and increased mortality in type II diabetes with HFpEF suggests a causative role for diastolic dysfunction.
Does normotensive type II diabetes mellitus cause asymptomatic left ventricular diastolic and systolic dysfunction compared to healthy controls?
Cross-Sectional (n=51)
No
Does normotensive type II diabetes mellitus cause asymptomatic left ventricular diastolic and systolic dysfunction compared to healthy controls?
Absolute Event Rate: 59% vs 28%
p-value: p=0.00018
Normotensive, asymptomatic patients with type II diabetes exhibit significant subclinical left ventricular diastolic and systolic dysfunction compared to healthy controls, highlighting the presence of early diabetic cardiomyopathy.
Normotensive type 2 diabetes may signal subclinical LV dysfunction; hypothesis-generating and should not yet alter practice.
Background: Diabetes is a major risk factor for impaired left ventricular function independent of coronary artery disease and hypertension. Left ventricular diastolic dysfunction is demonstrated in diabetic patients who are normotensive and have no symptoms of cardiac disease. Increased mortality is evident among type II diabetic patients with left ventricular failure with preserved ejection fraction also suggests its causative role diastolic dysfunction. Objective: To describe Left ventricular dysfunction in normotensive diabetic patients. Method: A Cross Sectional Study was undertaken in Comilla Medical College Hospital in 51 patients .29 diabetic patients with normal blood pressure (blood pressure ≤140/90 mmHg) who are not on anti-hypertensive medications and 22 healthy controls enrolled into the study. All patients and control subjects underwent transthoracic echocardiographic evaluation using GE LOGIQ V2 machine. The categorical variables described as frequencies and percentages, while continuous variables presented as medians and interquartile range (IQR) values and means and standard deviations. Continuous variables were compared using the Student’s t- test, while categorical parameters were analyzed with the Chi-square test or two tailed Fischer’s exact test as appropriate. A P-value of 0.05 or less was considered statistically significant. Result: Among 51 patients, 29 were cases and 22 were control. Male to female ratio was 1:1.7. The mean ages were 50.03±12.75 and 41.59±11.25 in case and control group respectively. The body mass index in two groups did not showed any significant difference (21.12±4.1 versus 20.91±3.60: P=0.374). The cases had a normal but significantly lower mean ejection fraction than controls (56.98±13.06 versus 62.48±7.73, respectively: P=0.033). Left ventricular diastolic filling pattern was abnormal in 17 (59%) cases and 6 (28%) in control group. The mean relative wall thickness (RWT) was higher in cases than controls. (0.47±0.11 versus .42±0.08; P= 0.014). Also the same difference observed in case of left ventricular mass index. (101.55±35.45 versus 86.98±28.01; P=0.053). The respondents were normotensive but abnormal filling pattern was observed in 17 (59%) and 6 (28%) in cases and control groups respectively which was significant. (P= 0.00018). Conclusion: Normotensive diabetic patients have asymptomatic diastolic dysfunction. J Com Med Col Teachers Asso July 2024; 28(2): 53-57
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Ali et al. (2024) conducted a cross-sectional in Normotensive Type II Diabetes Mellitus (n=51). Type II Diabetes Mellitus vs. Healthy controls was evaluated on Abnormal left ventricular diastolic filling pattern (p=0.00018). Normotensive type II diabetic patients had a significantly higher prevalence of abnormal left ventricular diastolic filling patterns compared to healthy controls (59% vs 28%, p=0.00018).
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