Peter Blomstrand1, Martin Engvall2, Karin Festin2, Torbjörn Lindström2, Toste Länne2, Eva Maret3, Fredrik H Nyström2, John Maret-Ouda4, Carl Johan Östgren2, Jan Engvall5. 1. Department of Clinical Physiology, County Hospital Ryhov, Jönköping 551 85, Sweden Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Högskoleområdet, Jönköping, Sweden Peter.Blomstrand@lj.se. 2. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. 3. Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden. 4. Department of Molecular Medicine and Surgery, Karolinska University Hospital, Stockholm, Sweden. 5. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden Department of Clinical Physiology, Linköping University, Linköping, Sweden Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
Abstract
AIMS: The aim of the study was to determine whether left ventricular systolic function, in terms of global left ventricular longitudinal strain (GLS), and diastolic function, expressed as the ratio between early diastolic transmitral flow and mitral annular motion velocities (E/e'), can predict cardiovascular events in patients with diabetes mellitus type 2. METHODS AND RESULTS: We prospectively investigated 406 consecutive patients, aged 55-65 years, with diabetes mellitus, who participated in the CARDIPP study. Echocardiography, pulse pressure (pp), and glycosylated haemoglobin (HbA1c) were analysed. Twelve cases of myocardial infarction and seven cases of stroke were identified during the follow-up period of 67 ± 17 months. Univariate Cox regression analysis showed that E/e' was a strong predictor of cardiovascular events (hazards ratio 1.12; 95% confidence interval 1.06-1.18, P < 0.001). E/e' was prospectively associated with cardiovascular events independent of age, sex, GLS, left ventricular ejection fraction (LVEF), pp, and HbA1c in multivariate analysis. Receiver operating characteristic curves showed that E/e' and HbA1c were the strongest predictors for cardiovascular events, both having an area under the curve (AUC) of 0.71 followed by LVEF with an AUC of 0.65 and GLS of 0.61. In a Kaplan-Meyer analysis, the cumulative probability of an event during the follow-up period was 8.6% for patients with an E/e' ratio >15 compared with 2.6% for patients with E/e' ≤15, P = 0.011. CONCLUSION: In middle-aged patients with type 2 diabetes, E/e' is a strong predictor of myocardial infarction and stroke, comparable with HbA1c and superior to GLS and LVEF.
AIMS: The aim of the study was to determine whether left ventricular systolic function, in terms of global left ventricular longitudinal strain (GLS), and diastolic function, expressed as the ratio between early diastolic transmitral flow and mitral annular motion velocities (E/e'), can predict cardiovascular events in patients with diabetes mellitus type 2. METHODS AND RESULTS: We prospectively investigated 406 consecutive patients, aged 55-65 years, with diabetes mellitus, who participated in the CARDIPP study. Echocardiography, pulse pressure (pp), and glycosylated haemoglobin (HbA1c) were analysed. Twelve cases of myocardial infarction and seven cases of stroke were identified during the follow-up period of 67 ± 17 months. Univariate Cox regression analysis showed that E/e' was a strong predictor of cardiovascular events (hazards ratio 1.12; 95% confidence interval 1.06-1.18, P < 0.001). E/e' was prospectively associated with cardiovascular events independent of age, sex, GLS, left ventricular ejection fraction (LVEF), pp, and HbA1c in multivariate analysis. Receiver operating characteristic curves showed that E/e' and HbA1c were the strongest predictors for cardiovascular events, both having an area under the curve (AUC) of 0.71 followed by LVEF with an AUC of 0.65 and GLS of 0.61. In a Kaplan-Meyer analysis, the cumulative probability of an event during the follow-up period was 8.6% for patients with an E/e' ratio >15 compared with 2.6% for patients with E/e' ≤15, P = 0.011. CONCLUSION: In middle-aged patients with type 2 diabetes, E/e' is a strong predictor of myocardial infarction and stroke, comparable with HbA1c and superior to GLS and LVEF.
Authors: Madhavi P Gavini; Abuzar Mahmood; Anthony M Belenchia; Paige Beauparlant; Senthil A Kumar; Sivakumar Ardhanari; Vincent G DeMarco; Lakshmi Pulakat Journal: Front Pharmacol Date: 2021-06-18 Impact factor: 5.810
Authors: Hyun Ju Yoon; Kye Hun Kim; Jong Yoon Kim; Jae Young Cho; Nam Sik Yoon; Hyung Wook Park; Young Joon Hong; Ju Han Kim; Youngkeun Ahn; Myung Ho Jeong; Jeong Gwan Cho; Jong Chun Park Journal: J Cardiovasc Ultrasound Date: 2015-09-24
Authors: Peter Blomstrand; Peter Sjöblom; Mats Nilsson; Magnus Wijkman; Martin Engvall; Toste Länne; Fredrik H Nyström; Carl Johan Östgren; Jan Engvall Journal: Cardiovasc Diabetol Date: 2018-08-14 Impact factor: 9.951