title: Is chronic diabetic foot ulcer an indicator of cardiac disease?
abstract: OBJECTIVE
  To evaluate presence and severity of cardiac disease in individuals with chronic diabetic foot ulcers using echocardiography.
  
  
  METHODS
  Eighty consecutive patients with chronic foot ulcers attending the multidisciplinary diabetes foot clinic at Helsingborg Hospital underwent clinical examination, toe blood pressure measurement and a standard echocardiographic examination.
  
  
  RESULTS
  Sixty-nine percent of the patients had a history of myocardial infarction and/or hypertension and/or heart failure; 78% had signs of left ventricular dysfunction and/or left ventricular hypertrophy and/or diastolic dysfunction; 76% of the patients without a history of cardiovascular disease had signs of cardiac dysfunction on echocardiography.
  
  
  CONCLUSIONS
  Cardiac dysfunction is a common occurrence present in patients with chronic diabetic foot ulcers, even in those without known cardiac disease or hypertension. Echocardiography may be recommended as a screening procedure in the management of diabetic patients with chronic foot ulcers. The present study supports the view that diabetic chronic foot ulcers ought to be seen as a sign of cardiac disease, although further research is needed to elucidate this issue.
authors.affiliation: Department of Endocrinology, Lund University Hospital, Sweden. magnus.londahl@skane.se
authors.forename: M
authors.initials: M
authors.lastname: Löndahl
authors.forename: P
authors.initials: P
authors.lastname: Katzman
authors.forename: O
authors.initials: O
authors.lastname: Fredholm
authors.forename: A
authors.initials: A
authors.lastname: Nilsson
authors.forename: J
authors.initials: J
authors.lastname: Apelqvist
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D017719:Diabetic Foot / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000378:metabolism; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology*; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013548:Sweden / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology