Observational Study Investigating the Prevalence of Asymptomatic Stage B Heart Failure in Patients with Type 2 Diabetes Who Are Not Known to Have Coronary Artery Disease

Overview

Journal BMJ Open

Specialty General Medicine

Date 2021 Jan 22

PMID 33478961

Citations 3

Authors

Mon Myat Oo

Isaiah Tan Chung Zhen

Kee Seong Ng

Kok Leng Tan

Alexander T B Tan

Shireene Ratna Vethakkan

R Jeyakantha AL Ratnasingam

Kok Han Chee

Affiliations

Soon will be listed here.

Abstract

Objective: To identify the prevalence of stage B heart failure (SBHF) in patients with type 2 diabetes mellitus (T2DM) with no history of cardiovascular disease (CVD).

Design: Observational study.

Setting: A single-centre study in which eligible patients were recruited from T2DM clinic. Following consent, patients completed a questionnaire and underwent physical examinations. Patients had blood drawn for laboratory investigations and had a transthoracic echocardiography.

Participants: A total of 305 patients who were not known to have CVD were recruited. Patients with deranged liver function tests and end stage renal failure were excluded.

Main Outcome Measures: Echocardiographic parameters such as left ventricular ejection fraction, left ventricular mass index (LVMI), left ventricular hypertrophy, left atrial enlargement and diastolic function were examined.

Results: A total of 305 patients predominantly females (65%), with mean body mass index of 27.5 kg/m participated in this study. None of them had either a history or signs and symptoms of CVD. Seventy-seven percent of patients had a history of hypertension and 83% of this study population had T2DM for more than 10 years. Mean HbA1c of 8.3% was recorded. Almost all patients were taking metformin. Approximately, 40% of patients were on newer anti-T2DM agents such as sodium-glucose cotransporter-2 and dipeptidyl peptidase 4 inhibitors. Fifty-seven percent (n=174) of the study population had SBHF at the time of study: diastolic dysfunction, increased LVMI and increased left atrial volume index (LAVI) were noted in 51 patients (17%), 128 patients (42%) and 98 patients (32%), respectively. Thirty-seven patients (12%) had both increase LVMI and LAVI.

Conclusion: Our study has revealed a high prevalence of SBHF in T2DM patients without overt cardiac disease in Malaysia that has one of the highest prevalence of TDM in the world.

Citing Articles

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Molecular and cellular mechanisms in diabetic heart failure: Potential therapeutic targets.

Mengstie M, Abebe E, Teklemariam A, Mulu A, Teshome A, Zewde E Front Endocrinol (Lausanne). 2022; 13:947294.

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Ma C, Ma X, Guan C, Li Y, Mauricio D, Fu S Cardiovasc Diabetol. 2022; 21(1):74.

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