Prevalence of Left Ventricular Diastolic Dysfunction in Normotensive Patients with Type 2 Diabetes Mellitus

The prevalence of type 2 diabetes mellitus (DM) has been increasing over the years, with cardiovascular disease being the leading cause of death. Diabetic cardiomyopathy is a clinical entity independent of coronary artery disease leading to heart failure in diabetic patients. Left ventricular diastolic dysfunction (LVDD) is an early manifestation of diabetic cardiomyopathy leading to significant morbidity and mortality.

The aim of this study was to evaluate LVDD in normotensive patients with type 2 DM and correlate the severity of diastolic dysfunction with glycemic control using glycated hemoglobin (HbA1c).

A hospital-based prospective observational study was conducted between January 2018 and June 2020 at a tertiary care hospital in Bengaluru, Karnataka, India. A total of 130 patients with type 2 DM without systemic hypertension were selected as the study population. Left ventricular function was assessed by performing a Doppler echocardiogram, and HbA1c was measured. Analysis of the data was done with the help of IBM SPSS statistics software 23.0 version.

One hundred and thirty patients (95 males and 35 females) were enrolled in our study, of which 55.4% (72 patients) had LVDD. Patients with LVDD were noticed to have a higher mean age ( P < 0.001). Comparison of HbA1c levels between the subset of patients with and without LVVD using unpaired t -test was statistically insignificant and did not correlate with LVDD. On the assessment of electrocardiographic parameters, the corrected QT duration (QTc) showed a positive correlation with LVDD which was statistically significant. On the assessment of echocardiographic findings, deceleration time and the ratio of early mitral inflow velocity and mitral annular early diastolic velocity (E/e) done using unpaired t -test showed positive correlations with LVDD which were statistically significant.

LVDD has a high prevalence in type 2 DM and is a cause of morbidity and mortality. Therefore, the detection of diabetic cardiomyopathy at an early stage with Doppler echocardiography has major therapeutic implications to prevent cardiovascular complications. Furthermore, it can aid the development of risk stratification strategies that can improve the quality of life and prevent morbidity.