1. Left ventricular dysfunction and outcome at two-year follow-up in patients with type 2 diabetes: The DYDA study
- Author
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Giovanni Cioffi, Valeria Manicardi, D Girfoglio, Paolo Verdecchia, Pompilio Faggiano, Serge Masson, Marco Comaschi, Mario Velussi, Andrea Di Lenarda, Augusto Travaglini, Aldo P. Maggioni, Donata Lucci, and Carlo Giorda
- Subjects
Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Diastole ,Type 2 diabetes ,Ventricular Dysfunction, Left ,Endocrinology ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Heart Failure ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Type 2 Diabetes Mellitus ,General Medicine ,Middle Aged ,medicine.disease ,Diabetes Mellitus, Type 2 ,Heart failure ,Cardiology ,Female ,business ,Lipid profile - Abstract
Aims Left ventricular dysfunction (LVD) in type 2 diabetes mellitus (DM) (DYDA) study is a prospective investigation enrolling 960 with DM without overt cardiac disease. At baseline, a high prevalence of LVD was detected by analysing midwall shortening. We report here the incidence of clinical events in DYDA patients after 2-year follow-up and the frequency of LVD detected at baseline and 2-year evaluation. Methods Systolic LVD was defined as midwall shortening ≤15%, diastolic LVD as any condition different from “normal diastolic function” identified as E/A ratio on Doppler mitral flow between 0.75 and 1.5 and deceleration time of E wave >140 ms. Major outcome was a composite of major events, including all-causes death and hospital admissions. Results During the study period, any systolic/diastolic LVD was found in 616 of 699 patients (88.1%) in whom LVD function could be measured at baseline or at 2 years. Older age and high HbA1c predicted the occurrence of LVD. During the follow-up 15 patients died (1.6%), 3 for cardiovascular causes, 139 were hospitalized (14.5%, 43 of them for cardiovascular causes, 20 for a new cancer). Conclusions During a 2-year follow-up any LVD is detectable in a large majority of patients with DM without overt cardiac disease. Older age and higher HbA1c predict LVD. All-cause death or hospitalization occurred in 15% of patients, cardiovascular cause was uncommon. Independent predictors of events were older age, pathologic lipid profile, high HbA1c, claudicatio and repaglinide therapy. Echo-assessed LVD at baseline was not prognosticator of events.
- Published
- 2013