The impact of diabetes duration on left ventricular diastolic function and cardiovascular disease
Yujeong Kim1, Mi-Seung Shin, Yeun Sun Kim
1Division of Cardiology, Department of Internal Medicine, Gachon University Gil Hospital, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, Korea.
Insights
Longer diabetes mellitus duration worsens left ventricular diastolic dysfunction. However, diabetes duration did not significantly correlate with cardiovascular disease risk in this study.
Area of Science:
- Cardiology
- Endocrinology
- Diabetology
Background:
- Diabetes mellitus (DM) is a global health concern.
- The relationship between DM duration and cardiac dysfunction requires further investigation.
- Left ventricular (LV) diastolic dysfunction is a known complication of DM.
Purpose of the Study:
- To investigate the correlation between the duration of diabetes mellitus and the severity of left ventricular diastolic dysfunction.
- To assess the association between DM duration and the risk of cardiovascular disease (CVD).
Main Methods:
- Retrospective review of 547 diabetic patients from January 2005 to April 2010.
- Echocardiographic assessment of 92 consecutive type 2 DM patients without ischemic heart disease or heart failure.
- Analysis of diastolic parameters and correlation with DM duration and CVD incidence.
Main Results:
- Diastolic dysfunction parameters significantly worsened with increasing DM duration (p<0.05).
- Patients with DM duration ≥7 years showed significantly increased E/Ea ratio and decreased Ea/Aa ratio compared to those with <7 years.
- Cardiovascular disease developed in 30.4% of patients, but DM duration showed a weak correlation with CVD incidence (p=0.188).
Conclusions:
- Diabetes mellitus duration is associated with worsening left ventricular diastolic dysfunction.
- Echocardiographic evaluation did not reveal significant differences in DM duration between patients with and without CVD.
- The rate of CVD development was not significantly different for DM durations exceeding 7 years.
- Proactive medical management, including echocardiography, is recommended from the diagnosis of type 2 DM to prevent CVD.
Objectives:
The question of whether diabetes mellitus (DM) duration correlates with the severity of dysfunction has not been well studied. We hypothesised that the longer the duration of DM the worse the severity of left ventricular (LV) diastolic dysfunction and increased risk of cardiovascular disease (CVD).
Methods:
We reviewed 547 diabetic patients between January 2005 and April 2010. Finally, 92 consecutive patients who presented with type 2 DM and who underwent echocardiographic assessment were enrolled according to the selection criteria. In all patients, ischaemic heart disease and heart failure were excluded.
Results:
Diastolic parameters were significantly worsened with increasing duration of DM (p<0.05). In the ≥7 years DM duration group (n=50), the E/Ea ratio increased significantly and the Ea/Aa ratio decreased significantly, compared with those in the <7 years DM duration group (n=42). CVD developed in 28 patients (30.4%) during the follow-up period. However, the duration of DM showed less statistical correlation with the incidence of CVD (p=0.188) and other LV diastolic function indices did not differ significantly between groups with or without CVD.
Conclusions:
Alteration of diastolic function induced by DM worsens with increasing duration of DM. DM duration on echocardiographic evaluation time did not differ significantly between the CVD incident and the non-CVD incident groups. The rate of CVD development was not significantly different if the duration of DM was more than 7 years. Therefore, active medical care including echocardiography should be undertaken to prevent CVD from the point of diagnosis of type 2 DM.
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