Prevalence and predictors of cardiac hypertrophy and dysfunction in patients with Type 2 diabetes.
The aim of the present study was to determine the prevalence and predictors of an abnormal echocardiogram in patients with Type 2 diabetes. Cardiac function and structure were rigorously assessed by comprehensive transthoracic echocardiographic techniques in 229 patients with Type 2 diabetes. Cardiovascular risk factors and diabetic complications were assessed, and predictors of an abnormal echocardiogram were identified using multivariate logistic regression analysis. An abnormal echocardiogram was present in 166 patients (72%). LVH (left ventricular hypertrophy) occurred in 116 patients (51%), and cardiac dysfunction was found in 146 patients (64%), of whom 109 had diastolic dysfunction alone and 37 had systolic+/-diastolic dysfunction. Independent predictors of an abnormal echocardiogram were obesity, age, the number of antihypertensive drugs used (all P<0.001) and creatinine clearance (P<0.05). The risk of an abnormal echocardiogram increased by 9% for each year over 50 years of age {OR (odds ratio), 1.09 [95% CI (confidence interval), 1.04-1.15]}, 3-fold if obesity was present [BMI (body mass index) >30; OR, 4.2 (95% CI, 1.9-9.0)] and by 80% for each antihypertensive agent used [OR, 1.8 (95% CI, 1.3-2.4) per agent]. In conclusion, an abnormal cardiac echocardiogram is common in patients with Type 2 diabetes. Importantly, although cardiac abnormalities can be predicted by traditional risk factors, such as age, obesity and renal function, the absence of micro- or macro-vascular complications does not predict a normal echocardiogram. We suggest that an echocardiogram identifies those with Type 2 diabetes at increased cardiovascular risk due to occult LVH and diastolic dysfunction, and this information may lead to more aggressive management of known risk factors in the clinic.
Srivastava
Piyush M
PM
Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3081, Australia.
Calafiore
Paul
P
Macisaac
Richard J
RJ
Patel
Sheila K
SK
Thomas
Merlin C
MC
Jerums
George
G
Burrell
Louise M
LM
D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D003401:Creatine / Q000378:metabolism; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000503:physiopathology; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009765:Obesity / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D015995:Prevalence
D000959:Antihypertensive Agents; D003401:Creatine