Progression of Subclinical Myocardial Dysfunction in Type 2 Diabetes after 5 years Despite Improved Glycemic Control.
Background: Patients with uncomplicated diabetes have reduced left ventricular long-axis function, related to poor glycemic control and increased conduit arterial stiffness, with increased radial function. It is unknown if improved control of risk factors can reverse these subclinical changes. Patie...
| Publicado en: | Echocardiography Vol. 29; no. 9; pp. 1045 - 1054 |
|---|---|
| Autores principales: | , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2012
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104422999&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104422999 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Oct2012 vid: 29 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104422999 82335802 10.1111/j.1540-8175.2012.01748.x NLM22672221 104422999 ppf: 1045 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Progression of Subclinical Myocardial Dysfunction in Type 2 Diabetes after 5 years Despite Improved Glycemic Control. aug: au: Vintila, Vlad Damian Roberts, Aled Vinereanu, Dragos Fraser, Alan Gordon affil: University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital of Bucharest, Romania sug: subj: Diabetes Mellitus, Type 2 Complications Glycemic Control Disease Progression Ventricular Dysfunction, Left Etiology Myocardial Diseases Etiology Human Descriptive Statistics Male Female Middle Age Echocardiography Methods Cross Sectional Studies Prospective Studies Record Review Intrarater Reliability Data Analysis Software T-Tests Chi Square Test Logistic Regression Funding Source Middle Aged: 45-64 years Male Female ab: Background: Patients with uncomplicated diabetes have reduced left ventricular long-axis function, related to poor glycemic control and increased conduit arterial stiffness, with increased radial function. It is unknown if improved control of risk factors can reverse these subclinical changes. Patients and methods: We studied 27 patients with type 2 diabetes (18 men) 57 ± 1 months (mean ± SD) after an initial visit when they were compared with healthy age- and sex-matched controls. On both visits patients had detailed echocardiographic studies including tissue Doppler, noninvasive tests of conduit arterial function, and metabolic and lipid profiling. Results: Mean age at this second review was 63.4 ± 8.1 years; 48% of patients received insulin. Mean HbA1c had decreased by 13% to 8 ± 1.6% and cholesterol by 17% to 4.3 ± 1.3 mmol/L (both, P < 0.01), but long-axis systolic and early diastolic myocardial velocities had also declined, by 13% and 20%, respectively (both, P < 0.001). Body mass index had increased by 4%, arterial pulse pressure by 17% (both P < 0.01), and carotid arterial stiffness by 49% (P < 0.01). Fractional shortening (by 21%, P < 0.001), radial systolic velocity (by 13%, P < 0.05), and ejection fraction (by 9% to 68 ± 7%, P < 0.01) had all declined. Reductions in longitudinal function were best predicted by its baseline measurements, duration of diabetes, fasting triglycerides, and arterial stiffness (epsilon index). Conclusions: Despite improved diabetic control, subclinical left ventricular dysfunction progressed over 5 years. Radial compensation was reversed. Prevention of subclinical myocardial dysfunction in diabetes might require more intensive control of net cardiovascular risk. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|