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Title: Prevalence, predictors and evolution of echocardiographically defined cardiac abnormalities in adults with type 1 diabetes: an observational cohort study.
Austin Authors: Wai, Bryan;Patel, Sheila K ;Ord, Michelle;MacIsaac, Richard J;Jerums, George ;Srivastava, Piyush M ;Burrell, Louise M 
Affiliation: Department of Cardiology, Austin Health, Melbourne, Australia
Endocrine Centre of Excellence, Austin Health, Melbourne, Australia
Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
Department of Endocrinology & Diabetes, St Vincent's Hospital & University of Melbourne, Melbourne, Australia
Issue Date: 7-Oct-2013
Publication information: Journal of Diabetes and Its Complications 2013; 28(1): 22-8
Abstract: The aims of this observational study were to determine the prevalence and predictors of an abnormal echocardiogram in adults with type 1 diabetes, and to assess the evolution of changes in a subset of subjects.Cardiac function and structure were prospectively investigated by comprehensive transthoracic echocardiographic techniques in asymptomatic adults with type 1 diabetes seen in the ambulatory care setting.We recruited 136 subjects (mean age 39 years, SD 14 years) with a median diabetes duration of 21 years [25(th), 75(th) interquartile range; 11, 29]. An abnormal echocardiogram was present in 29% of subjects; diastolic dysfunction in 69%, left ventricular hypertrophy in 38% and systolic dysfunction in 10%. The independent predictors of an abnormal echocardiogram were age, with a 9-fold increase in those ≥40 years (OR 9.40 [95% CI 2.68-33.04], P <0.0001), and increased body mass index (BMI), with a 17% increase in risk (P=0.04). A second echocardiogram was available in 65 subjects (3.8±1.7 years later). The results showed that one in five with a normal first study had developed an abnormal second study, mainly diastolic dysfunction, with age being the only independent predictor of progression (P=0.006).Subclinical echocardiographic abnormalities are common in asymptomatic type 1 diabetes adults, and changes are progressive. The addition of an echocardiogram to complication surveillance programs in those with type 1 diabetes aged ≥40 years may represent a cost-effective way to screen for, and aggressively treat, occult cardiac disease.
Gov't Doc #: 24210987
DOI: 10.1016/j.jdiacomp.2013.09.013
Journal: Journal of diabetes and its complications
Type: Journal Article
Subjects: Cardiac disease
Diastolic dysfunction
Left ventricular hypertrophy
Type 1 diabetes mellitus
Cohort Studies
Diabetes Mellitus, Type 1.complications.epidemiology.ultrasonography
Diabetic Cardiomyopathies.epidemiology.etiology.ultrasonography
Disease Progression
Echocardiography.statistics & numerical data
Heart Diseases.epidemiology.etiology.ultrasonography
Hypertrophy, Left Ventricular.epidemiology.etiology.ultrasonography
Middle Aged
Risk Factors
Ventricular Dysfunction, Left.epidemiology.etiology.ultrasonography
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