BACKGROUND: Better knowledge of prevalence and early-stage determinants of subclinical left ventricular dysfunction (LVD) in type 2 diabetes would be useful to design prevention strategies. The objective of the LVD in Diabetes (DYDA) study was to assess these points in patients without established cardiac disease. METHOD: Baseline clinical, ECG, laboratory and echocardiographic data from 751 patients (61 ± 7 years, 59% hypertensive) recruited by 37 Italian diabetes clinics were analysed. Clinical history, life habits, laboratory data (NT-proBNP, HsCRP, HbA1c, serum glucose, lipids and creatinine, liver enzymes, microalbuminuria, glomerular filtrate) and data on microvascular complications and drug therapy were collected. RESULTS: LVD was present in 59.9% of patients. Age (OR 1.05, 95% CI [1.02-1.07]), HbA1c (OR 1.27, 95% CI [1.09-1.49]), triglycerides (OR 1.003, 95% CI [1.001-1.006]), treatment with metformin (OR 1.62, 95% CI [1.09-2.40]) and doxazosine (OR 2.48, 95% CI [1.10-5.55]) were independent predictors of LVD. Glitazones were associated with reduced risk of diastolic dysfunction (OR 0.44, 95% CI [0.22-0.87]) whereas waist circumference and metformin were adversely associated with systolic dysfunction (OR 1.02, 95% CI [1.01-1.04] and 1.57, 95% CI [1.01-2.43], respectively). CONCLUSION: In asymptomatic and fairly controlled diabetic patients, age, worse HbA1c, traits of insulin resistance, such as visceral adiposity and triglycerides or treatment with metformin, and use of doxazosin indicate greater risk of LVD. Glitazones, at this stage, seem to be associated with better diastolic performance.
BACKGROUND: Better knowledge of prevalence and early-stage determinants of subclinical left ventricular dysfunction (LVD) in type 2 diabetes would be useful to design prevention strategies. The objective of the LVD in Diabetes (DYDA) study was to assess these points in patients without established cardiac disease. METHOD: Baseline clinical, ECG, laboratory and echocardiographic data from 751 patients (61 ± 7 years, 59% hypertensive) recruited by 37 Italian diabetes clinics were analysed. Clinical history, life habits, laboratory data (NT-proBNP, HsCRP, HbA1c, serum glucose, lipids and creatinine, liver enzymes, microalbuminuria, glomerular filtrate) and data on microvascular complications and drug therapy were collected. RESULTS: LVD was present in 59.9% of patients. Age (OR 1.05, 95% CI [1.02-1.07]), HbA1c (OR 1.27, 95% CI [1.09-1.49]), triglycerides (OR 1.003, 95% CI [1.001-1.006]), treatment with metformin (OR 1.62, 95% CI [1.09-2.40]) and doxazosine (OR 2.48, 95% CI [1.10-5.55]) were independent predictors of LVD. Glitazones were associated with reduced risk of diastolic dysfunction (OR 0.44, 95% CI [0.22-0.87]) whereas waist circumference and metformin were adversely associated with systolic dysfunction (OR 1.02, 95% CI [1.01-1.04] and 1.57, 95% CI [1.01-2.43], respectively). CONCLUSION: In asymptomatic and fairly controlled diabeticpatients, age, worse HbA1c, traits of insulin resistance, such as visceral adiposity and triglycerides or treatment with metformin, and use of doxazosin indicate greater risk of LVD. Glitazones, at this stage, seem to be associated with better diastolic performance.
Authors: Lotte Jacobs; Lutgarde Thijs; Yu Jin; Faiez Zannad; Alexandre Mebazaa; Philippe Rouet; Florence Pinet; Christophe Bauters; Burkert Pieske; Andreas Tomaschitz; Mamas Mamas; Javier Diez; Kenneth McDonald; John G F Cleland; Hans-Peter Brunner-La Rocca; Stephane Heymans; Roberto Latini; Serge Masson; Peter Sever; Christian Delles; Stuart Pocock; Timothy Collier; Tatiana Kuznetsova; Jan A Staessen Journal: J Biomed Res Date: 2014-07-31
Authors: João Pedro Ferreira; Nicolas Girerd; Pierpaolo Pellicori; Kevin Duarte; Sophie Girerd; Marc A Pfeffer; John J V McMurray; Bertram Pitt; Kenneth Dickstein; Lotte Jacobs; Jan A Staessen; Javed Butler; Roberto Latini; Serge Masson; Alexandre Mebazaa; Hans Peter Brunner-La Rocca; Christian Delles; Stephane Heymans; Naveed Sattar; J Wouter Jukema; John G Cleland; Faiez Zannad; Patrick Rossignol Journal: BMC Med Date: 2016-11-10 Impact factor: 8.775
Authors: Selim Kul; İhsan Dursun; Semiha Ayhan; Muhammet Rasit Sayin; Özge Üçüncü; Nilgün Esen Bülbül; Ahmet Hakan Ateş; Ali Rıza Akyüz Journal: Arq Bras Cardiol Date: 2019-07-29 Impact factor: 2.000
Authors: Serge Masson; Roberto Latini; Giovanni Cioffi; Renato Urso; Tarcisio Vago; Donata Lucci; Gian Francesco Mureddu; Luigi Tarantini; Pompilio Faggiano; Daniela Girfoglio; Mario Velussi; Aldo P Maggioni; Carlo B Giorda; Marco Comaschi Journal: Diabetes Care Date: 2013-09 Impact factor: 19.112