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Title: Prevalence and predictors of cardiac hypertrophy and dysfunction in patients with Type 2 diabetes.
Austin Authors: Srivastava, Piyush M ;Calafiore, Paul ;Macisaac, Richard J;Patel, Sheila K ;Thomas, Merlin C;Jerums, George ;Burrell, Louise M 
Affiliation: Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3081, Australia
Issue Date: 1-Feb-2008
Publication information: Clinical Science 2008; 114(4): 313-20
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.
Gov't Doc #: 17916064
DOI: 10.1042/CS20070261
Journal: Clinical Science
Type: Journal Article
Subjects: Aging.physiology
Analysis of Variance
Antihypertensive Agents.therapeutic use
Cross-Sectional Studies
Diabetes Complications.epidemiology.physiopathology.ultrasonography
Diabetes Mellitus, Type 2.physiopathology.ultrasonography
Echocardiography, Doppler
Logistic Models
Metabolic Clearance Rate
Middle Aged
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