Diabetes is associated with impaired myocardial performance in patients without significant coronary artery disease
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Key result
In patients without significant coronary artery disease, diabetes mellitus was associated with significantly reduced global longitudinal strain (15.9% vs. 17.7%) compared to matched controls.
Why the study?
Does diabetes mellitus impair myocardial performance in patients without significant coronary artery disease?
Population
62 patients with LVEF > 35% and without significant coronary artery disease, prior myocardial infarction…
Comparison
Diabetes mellitus (presence of the disease) vs Matched controls without diabetes mellitus
Design
Case-control, All echocardiograms were analyzed by one single investigator…
Authors
Discussion
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Implication
DM-associated myocardial impairment may occur without CAD; leaves open whether tissue Doppler screening improves HF risk stratification.
Study Design
Type
Case-Control (n=62)
Multicenter
No
Structured PICO
Does diabetes mellitus impair myocardial performance in patients without significant coronary artery disease?
P
Population
62 patients (mean age 58, 48% female) without significant coronary artery disease, comprising 31 with diabetes and 31 matched controls, evaluated for myocardial performance using echocardiography.
E
Exposure
Diabetes mellitus (presence of the disease)
C
Comparator
Matched controls without diabetes mellitus (matched on age, gender, and presence of hypertension)
O
Outcome
Echocardiographic tissue Doppler imaging parameters (peak longitudinal systolic velocity [S'], early diastolic velocity [E'], and global longitudinal strain)surrogate
Main Result
Absolute Event Rate: 15.9% vs 17.7%
p-value: p=0.03
In patients without significant coronary artery disease, diabetes mellitus is independently associated with subclinical impairments in systolic longitudinal left ventricular function and global diastolic dysfunction.
Limitations
- Some echocardiograms were carried out after coronary angiography, risking inclusion of patients with clinically silent but significant coronary stenosis.
- Patients with diabetes had a higher prevalence of hypertension despite attempted matching.
- Automated Function Imaging (AFI) measurements were lacking in 12 patients.
- Lack of data on HbA1c, diabetes duration, and detailed medical therapies.
- Retrospective register-based design
- Time delay between coronary angiography and echocardiogram with risk of silent CAD developing
- Higher prevalence of hypertension in DM group despite matching
- Missing AFI measurements in 12 patients
- Lack of data on HbA1c, diabetes duration, and detailed medical therapies
Cite This Study
Andersson et al. (2010) conducted a case-control in Diabetes mellitus without significant coronary artery disease (n=62). Diabetes mellitus vs. Matched controls without diabetes was evaluated on Global longitudinal strain (%) (p=0.03). In patients without significant coronary artery disease, diabetes mellitus was associated with significantly reduced global longitudinal strain (15.9% vs. 17.7%) compared to matched controls.
Topics
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