Anne Pernille Ofstad1, Odd Erik Johansen2, Lars Gullestad3, Kåre I Birkeland4, Elsa Orvik2, Morten W Fagerland5, Stig Urheim6, Svend Aakhus6. 1. Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Norway. Electronic address: Annepernille@hotmail.com. 2. Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Norway. 3. Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway; K.G. Jebsen Cardiac Research Centre and Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway. 4. Department of Endocrinology, Morbid Obesity, and Preventive Medicine, Oslo University Hospital Aker, Oslo, Norway. 5. Unit of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway. 6. Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
Abstract
BACKGROUND:Patients with type 2 diabetes (T2D) are prone to develop preclinical myocardial dysfunction, but no single strategy to prevent progression to heart failure has been established. We aimed to assess whether intensified global cardiovascular (CV) risk factor control would improve left ventricular (LV) systolic and diastolic function as compared with standard of care. METHODS: A total of 100 patients with ≥1 CV risk factor (29% female, mean ± SD age 58 ± 10 years, LV ejection fraction 63 ± 8%, 16% with LV diastolic dysfunction) were randomized to 2 years of intensified CV risk multi-intervention (INT, n = 50) or standard care (STAND, n = 50). Echocardiography, including tissue Doppler imaging, and maximum exercise test were performed at baseline and study end. Multi-intervention comprised lifestyle intervention and pharmacologic treatment to reach strict prespecified CV risk factor goals, whereas STAND group received current guideline care. RESULTS: Greater reductions were observed for hemoglobin A1c and total cholesterol in the INT group (P < .001 and P = .021, respectively), whereas blood pressure reduction was similar. Work capacity increased in INT and decreased in STAND (P = .014). There was no significant between-group difference in the change in any of the echocardiographic parameters. CONCLUSIONS: Two years of intensified multi-intervention in patients with T2D improved work capacity and glycemic and lipid control and had no significant benefit or harm on resting cardiac function.
RCT Entities:
BACKGROUND:Patients with type 2 diabetes (T2D) are prone to develop preclinical myocardial dysfunction, but no single strategy to prevent progression to heart failure has been established. We aimed to assess whether intensified global cardiovascular (CV) risk factor control would improve left ventricular (LV) systolic and diastolic function as compared with standard of care. METHODS: A total of 100 patients with ≥1 CV risk factor (29% female, mean ± SD age 58 ± 10 years, LV ejection fraction 63 ± 8%, 16% with LV diastolic dysfunction) were randomized to 2 years of intensified CV risk multi-intervention (INT, n = 50) or standard care (STAND, n = 50). Echocardiography, including tissue Doppler imaging, and maximum exercise test were performed at baseline and study end. Multi-intervention comprised lifestyle intervention and pharmacologic treatment to reach strict prespecified CV risk factor goals, whereas STAND group received current guideline care. RESULTS: Greater reductions were observed for hemoglobin A1c and total cholesterol in the INT group (P < .001 and P = .021, respectively), whereas blood pressure reduction was similar. Work capacity increased in INT and decreased in STAND (P = .014). There was no significant between-group difference in the change in any of the echocardiographic parameters. CONCLUSIONS: Two years of intensified multi-intervention in patients with T2D improved work capacity and glycemic and lipid control and had no significant benefit or harm on resting cardiac function.
Authors: Elena Succurro; Sofia Miceli; Teresa Vanessa Fiorentino; Angela Sciacqua; Maria Perticone; Francesco Andreozzi; Giorgio Sesti Journal: Cardiovasc Diabetol Date: 2021-03-06 Impact factor: 9.951
Authors: Silvio E Inzucchi; Kamlesh Khunti; David H Fitchett; Christoph Wanner; Michaela Mattheus; Jyothis T George; Anne Pernille Ofstad; Bernard Zinman Journal: J Clin Endocrinol Metab Date: 2020-09-01 Impact factor: 5.958