Subclinical left ventricular dysfunction was associated with a higher rate of all-cause mortality and hospitalization compared to normal LV function (37% vs 24%; p=0.030).
Cohort (n=230)
Does subclinical LV dysfunction detected by GLS predict all-cause mortality and hospitalization in asymptomatic patients with type 2 diabetes mellitus and normal EF?
Subclinical LV dysfunction detected by GLS is common in asymptomatic type 2 diabetes patients with normal EF and is independently associated with an increased risk of mortality and hospitalization.
Hazard Ratio: 1.1
Absolute Event Rate: 37% vs 24%
p-value: p=0.04
OBJECTIVE: New imaging techniques have permitted the detection of subclinical LV dysfunction (LVD) in up to half of patients with type 2 diabetes mellitus (DM) with a normal EF. However, the connection between early LVD and prognosis is unclear. This study aimed to define the long-term outcome of LVD associated with type 2 DM. METHODS: In this prospective cohort study, 230 asymptomatic patients with type 2 DM underwent measurement of global longitudinal 2D strain (GLS) for detection of LVD and were followed for up to 10 years. All subjects had normal EF (≥50%) and no evidence of coronary artery disease at recruitment. Outcome data were obtained through centralised state-wide death and hospital admission registries. The primary endpoint was all-cause mortality and hospitalisation. RESULTS: On study entry, almost half (45%) of the cohort had evidence of LVD as detected by GLS. Over a median follow-up of 7.4±2.6 years (range 0.6-9.7 years), 68 patients (30%) met the primary endpoint (LVD: 37%; normal LV function: 24%). GLS was independently associated with the primary endpoint (HR=1.10; p=0.04), as was systolic blood pressure (HR=1.02; p<0.001) and levels of glycosylated haemoglobin (HR=1.28; p=0.011). Patients with LVD had significantly worse outcome than those without (χ(2)=4.73; p=0.030). CONCLUSIONS: Subclinical LVD is common in asymptomatic patients with type 2 DM, is readily detectable by GLS imaging and is independently associated with adverse outcome. TRIAL REGISTRATION NUMBER: Australian and New Zealand Clinical Trials Registry (ACTRN12612001178831).
Holland et al. (2015) conducted a cohort in Type 2 diabetes mellitus (n=230). Subclinical LV dysfunction vs. Normal LV function was evaluated on All-cause mortality and hospitalisation (HR 1.10, p=0.04). Subclinical left ventricular dysfunction was associated with a higher rate of all-cause mortality and hospitalization compared to normal LV function (37% vs 24%; p=0.030).