What is the clinical evidence from this study?

Study design: Cohort. Population: type 2 diabetes mellitus (n=406). Intervention: E/e' ratio vs. E/e' ≤15. Primary outcome: cardiovascular events (myocardial infarction and stroke) (HR 1.12, 95% CI 1.06-1.18, p=<0.001).

What does this research mean for the field?

In middle-aged patients with type 2 diabetes, left ventricular diastolic function (E/e') is a strong predictor of cardiovascular events, comparable to HbA1c and superior to global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF). Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether left ventricular systolic function (GLS) and diastolic function (E/e') predict cardiovascular events in patients with type 2 diabetes mellitus.

March 6, 2015European Heart Journal - Cardiovascular ImagingOpen Access

Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes

Q: What are the key findings of this study?

In patients with type 2 diabetes, an E/e' ratio >15 was associated with a higher cumulative probability of cardiovascular events compared to E/e' ≤15 (8.6% vs 2.6%, P=0.011).

Q: What does this research mean for the field?

In middle-aged patients with type 2 diabetes, left ventricular diastolic function (E/e') is a strong predictor of cardiovascular events, comparable to HbA1c and superior to global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF). Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine whether left ventricular systolic function (GLS) and diastolic function (E/e') predict cardiovascular events in patients with type 2 diabetes mellitus.

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Key result

E/e' >15 linked to ~12% higher cardiovascular event risk in type 2 diabetes.

HR 1.12
95% CI 1.06-1.18
P<0.001
n=406

Why the study?

Does echocardiographic assessment of diastolic function (E/e') predict cardiovascular events better than global longitudinal strain (GLS) in patients with type 2 diabetes?

Population

n=406 consecutive patients, aged 55-65 years, with diabetes mellitus type 2 (CARDIPP study)

Design

Cohort

Follow-up

67 ± 17 months

Authors

PBPeter BlomstrandLinköping University MEMartin EngvallKarolinska University Hospital KFKarin FestinLinköping University

Discussion

Member takes

Implication

E/e' may aid CV risk stratification in type 2 diabetes; leaves open superiority over GLS in prospective studies.

Key Points

To determine whether left ventricular systolic function (GLS) and diastolic function (E/e') predict cardiovascular events in patients with type 2 diabetes mellitus.
Prospectively evaluated 406 consecutive patients aged 55–65 years with type 2 diabetes in the CARDIPP study over a follow-up of 67 ± 17 months.
Assessed echocardiographic measures including E/e', global left ventricular longitudinal strain (GLS), and left ventricular ejection fraction (LVEF), alongside pulse pressure and HbA1c.
Over follow-up, 12 myocardial infarctions and 7 strokes occurred, with E/e' independently predicting events in univariate (HR 1.12, 95% CI 1.06–1.18, P < 0.001) and multivariate analyses.
Receiver operating characteristic analysis showed E/e' and HbA1c had the highest predictive accuracy (both AUC 0.71), surpassing LVEF (AUC 0.65) and GLS (AUC 0.61).
Cumulative event probability was significantly higher in patients with E/e' > 15 at 8.6% compared to 2.6% in patients with E/e' ≤ 15 (P = 0.011).

Study Design

Type

Cohort (n=406)

Structured PICO

Does echocardiographic assessment of diastolic function (E/e') predict cardiovascular events better than global longitudinal strain (GLS) in patients with type 2 diabetes?

Population

n=406 consecutive patients, aged 55-65 years, with diabetes mellitus type 2 (CARDIPP study)

Intervention

Echocardiographic assessment of diastolic function (E/e' ratio) and systolic function (global left ventricular longitudinal strain [GLS])

Outcome

Cardiovascular events (myocardial infarction and stroke)hard clinical

Main Result

Effect estimate: HR 1.12 (95% CI 1.06-1.18)

Absolute Event Rate: 8.6% vs 2.6%

p-value: p=<0.001

In middle-aged patients with type 2 diabetes, diastolic function assessed by E/e' is a stronger predictor of future cardiovascular events than systolic function assessed by GLS or LVEF.

Cite This Study

Blomstrand et al. (2015) conducted a cohort in type 2 diabetes mellitus (n=406). E/e' ratio vs. E/e' ≤15 was evaluated on cardiovascular events (myocardial infarction and stroke) (HR 1.12, 95% CI 1.06-1.18, p=<0.001). In patients with type 2 diabetes, an E/e' ratio >15 was associated with a higher cumulative probability of cardiovascular events compared to E/e' ≤15 (8.6% vs 2.6%, P=0.011).

synapsesocial.com/papers/6a092ecc89dc12f767d25fe6 https://doi.org/10.1093/ehjci/jev027

Topics

Echocardiography

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Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider