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Published on: February 20, 2017
Left ventricular anatomical and functional changes with ageing in type 2 diabetic adults
Alexander Stefanidis1, Stavros Bousboulas, John Kalafatis
11st Department of Cardiology, General Hospital of Nicea, 3 D. Mantouvalou Street, 184-54 Piraeus, Greece. plato203@yahoo.com
Insights
Type 2 diabetes patients develop early systolic and diastolic myocardial dysfunction. This preclinical diabetic cardiomyopathy manifests before age-related changes, impacting heart function in diabetic individuals.
Area of Science:
- Cardiology
- Diabetology
- Echocardiography
Background:
- Type 2 diabetes is linked to myocardial dysfunction.
- Previous echocardiographic studies suggest coexisting systolic and diastolic impairment in diabetic patients.
- No systematic investigation of age-related left ventricular changes in type 2 diabetes exists.
Purpose of the Study:
- To investigate serial age-related changes in left ventricular anatomy and function in type 2 diabetic patients.
- To compare myocardial function between diabetic patients and non-diabetic controls across different age groups.
- To identify predictors of systolic myocardial dysfunction in type 2 diabetes.
Main Methods:
- Studied 160 type 2 diabetic patients and 110 controls, stratified into four age groups.
- Utilized comprehensive echocardiographic examination, including tissue Doppler imaging.
- Analyzed conventional systolic and diastolic parameters and longitudinal myocardial function.
Main Results:
- Tissue Doppler imaging revealed impaired systolic and diastolic longitudinal myocardial function in diabetic patients, except in the youngest group.
- Diastolic dysfunction appeared concomitantly in both groups by age 46-60.
- Diabetic patients exhibited earlier systolic dysfunction, indicated by lower myocardial velocity in the 46-60 age group.
- Age, glycated hemoglobin, and blood pressure predicted systolic myocardial dysfunction.
Conclusions:
- Type 2 diabetes patients experience early, concurrent systolic and diastolic myocardial dysfunction.
- This dysfunction represents a preclinical manifestation of diabetic cardiomyopathy.
- Diabetic cardiomyopathy impacts myocardial function at an earlier stage than previously recognized.
Aims:
Previous studies indicate that diabetic patients show evidence of coexisting systolic and diastolic myocardial dysfunction when examined by new echocardiographic techniques. Yet, there is no systematic investigation of the serial age-related changes of left ventricular anatomy and function in this patient population.
Methods And Results:
One hundred and sixty type 2 diabetic patients and 110 non-diabetic controls, all with no evidence of heart disease, were studied. The participants were stratified into four distinct age-groups (A: <46, B: 46-60, C: 61-75, and D: >75 years) and underwent full echocardiographic examination. Conventional systolic and diastolic parameters were similar between the study groups. However, tissue Doppler imaging examination revealed an impaired systolic and diastolic longitudinal myocardial function in diabetic patients vs. controls, although these differences were not noticed within the youngest age-group. Diastolic dysfunction was established concomitantly in both diabetic and control subjects in age-group B. In contrast, diabetic patients showed an earlier induction of myocardial systolic dysfunction, evidenced by significantly lower average systolic longitudinal myocardial velocity in age-group B. Independent predictors of systolic myocardial dysfunction were age, glycated haemoglobin, and systemic blood pressure.
Conclusion:
Type 2 diabetic patients demonstrate an early and concomitant induction of systolic and diastolic myocardial dysfunction as a preclinical manifestation of diabetic cardiomyopathy.
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