Prevalence and predictors of cardiac hypertrophy and dysfunction in patients with Type 2 diabetes

Piyush M. Srivastava, Paul Calafiore, Richard K. MacIsaac, Sheila K. Patel, Merlin C. Thomas, George Jerums, Louise M. Burrell

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38 Citations (Scopus)

Abstract

The aim of the present study was to determine the prevalence and predictors of an abnormal echocardiogram in patients with Type 2 diabetes. Cardiac function and structure were rigorously assessed by comprehensive transthoracic echocardiographic techniques in 229 patients with Type 2 diabetes. Cardiovascular risk factors and diabetic complications were assessed, and predictors of an abnormal echocardiogram were identified using multivariate logistic regression analysis. An abnormal echocardiogram was present in 166 patients (72%). LVH (left ventricular hypertrophy) occurred in 116 patients (51 %), and cardiac dysfunction was found in 146 patients (64%), of whom 109 had diastolic dysfunction alone and 37 had systolic ± diastolic dysfunction. Independent predictors of an abnormal echocardiogram were obesity, age, the number of antihypertensive drugs used (all P < 0.001) and creatinine clearance (P < 0.05). The risk of an abnormal echocardiogram increased by 9% for each year over 50 years of age {OR (odds ratio), 1.09 [95% CI (confidence interval), 1.04-1.15]}, 3-fold if obesity was present [BMI (body mass index) > 30; OR, 4.2 (95 % CI, 1.9-9.0)] and by 80 % for each antihypertensive agent used [OR, 1.8 (95 % CI, 1.3-2.4) per agent]. In conclusion, an abnormal cardiac echocardiogram is common in patients with Type 2 diabetes. Importantly, although cardiac abnormalities can be predicted by traditional risk factors, such as age, obesity and renal function, the absence of micro- or macro-vascular complications does not predict a normal echocardiogram. We suggest that an echocardiogram identifies those with Type 2 diabetes at increased cardiovascular risk due to occult LVH and diastolic dysfunction, and this information may lead to more aggressive management of known risk factors in the clinic.

Original languageEnglish
Pages (from-to)313-320
Number of pages8
JournalClinical Science
Volume114
Issue number3-4
DOIs
Publication statusPublished - 1 Feb 2008
Externally publishedYes

Keywords

  • Cardiovascular risk
  • Echocardiography
  • Left ventricular hypertrophy
  • Tissue Doppler imaging
  • Type 2 diabetes

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