Key result
Diabetic retinopathy is linked to ~420% greater odds of sub-clinical LV dysfunction in asymptomatic T2D.
Why the study?
The study was conducted to estimate the prevalence of sub-clinical left ventricular dysfunction among asymptomatic type 2 diabetic patients and assess its association with microvascular complications.
Is sub-clinical left ventricular dysfunction associated with microvascular complications in asymptomatic type 2 diabetic patients?
Cross-Sectional (n=226)
No
Is sub-clinical left ventricular dysfunction associated with microvascular complications in asymptomatic type 2 diabetic patients?
Effect estimate: OR 5.20 (95% CI 2.780-9.728)
Absolute Event Rate: 54.5% vs 18.8%
p-value: p=<0.0001
Sub-clinical left ventricular dysfunction detected by strain echocardiography is highly prevalent in asymptomatic type 2 diabetics with microvascular complications, suggesting a potential role for routine screening.
May support targeted strain imaging in asymptomatic T2DM with microvascular complications; hypothesis-generating pending prospective validation.
OBJECTIVE: The primary objective of the study was to estimate the prevalence of sub-clinical left ventricular dysfunction among asymptomatic diabetic patients, while the secondary objectives were to determine its association with microvascular complications and to find correlation with the baseline clinical and demographic parameters. MATERIAL AND METHODOLOGY: This was a cross-sectional study conducted on 226 type 2 diabetic patients who did not have any diagnosed cardiac disease, baseline ECG abnormality or cardiac symptoms. Two-dimensional strain echocardiography was performed to estimate the prevalence of left ventricular systolic dysfunction by measuring global longitudinal strain rate (cutoff < 18). Its association with microvascular complications was analysed with SPSS 23 software. Other baseline clinical parameters and demographic profile were also analysed. RESULT: < 0.0001) in addition to dyslipidaemia, history of hypertension, higher body mass index and poor glycaemic parameters. Among them, proteinuria showed a linear inverse relationship without any specific cutoff value. CONCLUSION: It was found that sub-clinical left ventricular dysfunction was found in significantly high proportion among patients with microvascular complications. Hence, routine screening of all diabetics for such complications and subsequently high-risk patients undergoing strain echocardiography can be a very cost-effective diagnostic, therapeutic and prognostic modality.
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Roy et al. (2020) conducted a cross-sectional in Type 2 diabetes mellitus (n=226). Diabetic retinopathy vs. Absence of diabetic retinopathy was evaluated on Sub-clinical left ventricular dysfunction (global longitudinal strain < 18%) (OR 5.20, 95% CI 2.780-9.728, p=<0.0001). Diabetic retinopathy and neuropathy were strongly associated with sub-clinical left ventricular dysfunction in asymptomatic type 2 diabetic patients, increasing the odds by 5.20 and 3.48 times, respectively.
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