Diastolic function deterioration in type 2 diabetes mellitus: predictive factors over a 3-year follow-up.
Diastolic dysfunction is frequent in patients with type 2 diabetes mellitus (DM2) and associated with a poor prognosis. This study aimed to describe diastolic function changes over time in DM2 patients and to identify predictive factors of diastolic function deterioration.



Diastolic function was assessed by echocardiography according to the EACVI/ASE recommendations at baseline and 3-year follow-up in a prospective cohort of 310 DM2 patients without overt heart disease. Predictors of diastolic function deterioration were identified using logistic regression analysis. During the 3-year follow-up, prevalence of diastolic dysfunction increased from 49% to 67% (P = 0.001). Only 32% of the patients had a normal diastolic function both at baseline and 3 years and 27% of the patients presented diastolic function deterioration. At multivariable analysis, age (OR = 1.05 [1.01-1.09], P < 0.01), retinopathy (OR = 2.00 [1.10-3.63], P = 0.02), and increase in systolic blood pressure during follow-up (OR = 1.03 [1.01-1.04], P < 0.01) were predictive of diastolic function deterioration.



Age, retinopathy, and increase in blood pressure over time are associated with an increased risk of diastolic function deterioration in DM2 patients. The presence of these co-factors might help to early identify patients at risk of heart failure.
Service des explorations fonctionnelles cardiovasculaires, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.|Centre d'Investigation Clinique, INSERM 1407, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.
Cyrille
C
Bergerot
Service des explorations fonctionnelles cardiovasculaires, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.|Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway.
Einar Skulstad
ES
Davidsen
Service des explorations fonctionnelles cardiovasculaires, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.
Camille
C
Amaz
Service des explorations fonctionnelles cardiovasculaires, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.|Centre d'Investigation Clinique, INSERM 1407, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.
Hélène
H
Thibault
Service des explorations fonctionnelles cardiovasculaires, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.
Mikhail
M
Altman
Department of endocrinology, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.
Amandine
A
Bellaton
Department of endocrinology, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677 BRON Cedex, France.
Philippe
P
Moulin
Service des explorations fonctionnelles, DHU Ageing-Thorax-Vessel-Blood, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France.|INSERM U955, team08, Université Paris-Est Créteil (UPEC), France.
Geneviève
G
Derumeaux
Service des explorations fonctionnelles, DHU Ageing-Thorax-Vessel-Blood, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France.|INSERM U955, team08, Université Paris-Est Créteil (UPEC), France.
Laura
L
Ernande
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D003971:Diastole; D018450:Disease Progression; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*
diastole; echocardiography; longitudinal study; type 2 diabetes