RT Journal Article
SR Electronic
T1 Subclinical LV dysfunction and 10-year outcomes in type 2 diabetes mellitus
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1061
OP 1066
DO 10.1136/heartjnl-2014-307391
VO 101
IS 13
A1 David J Holland
A1 Thomas H Marwick
A1 Brian A Haluska
A1 Rodel Leano
A1 Matthew D Hordern
A1 James L Hare
A1 Zhi You Fang
A1 Johannes B Prins
A1 Tony Stanton
YR 2015
UL http://heart.bmj.com/content/101/13/1061.abstract
AB Objective New imaging techniques have permitted the detection of subclinical LV dysfunction (LVD) in up to half of patients with type 2 diabetes mellitus (DM) with a normal EF. However, the connection between early LVD and prognosis is unclear. This study aimed to define the long-term outcome of LVD associated with type 2 DM.Methods In this prospective cohort study, 230 asymptomatic patients with type 2 DM underwent measurement of global longitudinal 2D strain (GLS) for detection of LVD and were followed for up to 10 years. All subjects had normal EF (≥50%) and no evidence of coronary artery disease at recruitment. Outcome data were obtained through centralised state-wide death and hospital admission registries. The primary endpoint was all-cause mortality and hospitalisation.Results On study entry, almost half (45%) of the cohort had evidence of LVD as detected by GLS. Over a median follow-up of 7.4±2.6 years (range 0.6–9.7 years), 68 patients (30%) met the primary endpoint (LVD: 37%; normal LV function: 24%). GLS was independently associated with the primary endpoint (HR=1.10; p=0.04), as was systolic blood pressure (HR=1.02; p<0.001) and levels of glycosylated haemoglobin (HR=1.28; p=0.011). Patients with LVD had significantly worse outcome than those without (χ2=4.73; p=0.030).Conclusions Subclinical LVD is common in asymptomatic patients with type 2 DM, is readily detectable by GLS imaging and is independently associated with adverse outcome.Trial registration number Australian and New Zealand Clinical Trials Registry (ACTRN12612001178831).