Holland, DJ and Marwick, TH and Haluska, BA and Leano, R and Hordern, MD and Hare, JL and Fang, ZY and Prins, JB and Stanton, T, Subclinical LV dysfunction and 10-year outcomes in type 2 diabetes mellitus, Heart, 101, (13) pp. 1061-1066. ISSN 1355-6037 (2015) [Refereed Article]
Copyright Article author (or their employer) 2015. Produced by BMJ Publishing Group Ltd (& BCS) under licence
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 (χ2=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.
|Item Type:||Refereed Article|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Marwick, TH (Professor Tom Marwick)|
|Web of Science® Times Cited:||81|
|Deposited By:||Menzies Institute for Medical Research|
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