Evaluation of Echocardiographic Findings in Type II DM of North Indian Patients with or Without Cardiac Disease

Title: Evaluation of Echocardiographic Findings in Type II DM of North Indian Patients with or Without Cardiac Disease

Authors: Rajendra Kumar Verma, Shivendra Verma, Richa Giri, Vimlesh, Nirmala Singh

DOI: http://dx.doi.org/10.18535/jmscr/v4i4.03

Abstract

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Abstract

The objective of our study was to determine whether there is statistically significant association between diastolic dysfunction in the asymptomatic and symptomatic (cardiac disease) subjects with type 2 diabetes mellitus and its relation to age, duration of DM, HbA1c, blood pressure, microalbuminuria and e GFR. In this cross-sectional study 90 subjects with type 2 diabetes were categorize in two groups after appropriate inclusion and exclusion criteria. Statistical analysis was done using SPSS 17.0. From this study we conclude that patients of type 2 diabetes mellitus without cardiac disease (asymptomatic) do have left ventricular diastolic dysfunction as well as left ventricular systolic dysfunction and this dysfunction increases with duration of diabetes mellitus, higher blood pressure, higher Hba1c levels and presence of albuminuria but has no significant correlation with eGFR. Strict watch and control of these parameters will help to delay the onset of cardiac disease in asymptomatic patients of type 2 diabetes mellitus.

Keywords- Type 2 Diabetes mellitus, Diastolic dysfunction, Systolic dysfunction, Hba1c, microalbuminuria, eGFR.

References

1. Kleinman JC, Donahue RP, Harris MI, Finucane FF, Madans JH, Brock DB. Mortality among diabetes in a national sample. Am J Epidemiol 1988;128:389-401.

2. Rask-Madsen C et al. Mechanisms of disease: Endothelial dysfunction in insulin resistance and diabetes. Nat Clin Pract Endocrinol Metab. 2007;3:46–56.

3. Khera A et al. Management of diabetic dyslipidemia: Need for reappraisal of the goals. Am J Cardiovasc Drugs. 2005;5:83.

4. Libby P et al. Inflammation in diabetes mellitus: Role of peroxisome proliferator–activated receptor-alpha and peroxisome proliferator–activated receptor-gamma agonists. Am J Cardiol. 2007;99:27B–40.

5. Mathewkutty S et al. Platelet perturbations in diabetes: Implications for cardiovascular disease risk and treatment. Expert Rev CardiovascTher. 2009;7:541–9.

6. Shindler DM, Kostis JB, Yusuf S, Quinones MA, Pitt B, Stewart D, et al. Diabetes mellitus, a predictor of morbidity and mortality in the Studies of Left Ventricular Dysfunction (SOLVD) Trials and Reg-istry. Am J Cardiol 1996;77(11):1017-20.

7. Bertoni AG, Tsai A, Kasper EK, Brancati FL. Diabetes and idiopathic cardiomyopathy: a nationwide case-control study. Diabetes Care 2003;26(10):2791-5.

8. Williams SB, Cusco JA, Roddy MA, Johnstone MT, Creager MA. Impaired nitric oxide-mediated vasodilation in patients with non-insulin dependent diabetes mellitus. J Am Coll Cardiol 1996; 27:567-74.

9. Williams SB, Goldfine AB, Timimi FK, Ting HH, Roddy MA, Simonson DC, et al. Acute hyperglycemia attenuates endothelium-dependent vasodilation in humans in vivo. Circulation 1998; 97:1695-701.

10. Solang I, Malmberg K, Ryden I. Diabetes Mellitus and congestive heart failure. Eur Heart J 1999; 20:789-95.

11. Rubler S, Dlugash J, Yuceoglu YZ, Kumral T, Branwood AW, Grishman A. New type of cardiomyopathy associated with diabetic glomerulosclerosis. Am J Cardiol 1972;30(6):595-602.

12. Fein, F.S., Sonnenblick, EH: Diabetic Cardiomyopathy. Progcardiovasc Dis 1985, 255 - 70.

13. Kazik A, Wilczek K, Poloński L. Management of diastolic heart failure. Cardiol J. 2010;17:558–65.

14. Fang ZY, Prins JB, Marwick TH. Diabetic cardiomyopathy: evidence, mechanisms, and therapeutic implications. Endocr Rev 2004; 25(4):543-67.

15. Hamby ,R,I. ; Zoneraich, S., Sherma, L. et al : Cardiomyopathy, JAMA 1974, 229: 1749.- 54.

16. Vijan S, Hayward RA et al. Treatment of hypertension in type 2 diabetes mellitus: Blood pressure goals, choice of agents, and setting priorities in diabetes care. Ann Intern Med 2003; 138:59.

17. Estacio RO et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med. 1998;338(10):645–652.

18. Donahue et al. Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program. Diabetes. 1987;36(6):689–692.

19. Jarrett RJ et al. The Bedford Survey: ten year mortality rates in newly diagnosed diabetics, borderline diabetics and normoglycaemic controls and risk indices for coronary heart disease in borderline diabetics. Diabetologia. 1982;22(2):79–84.

20. McGill HC Jr et al, Strong JP.Relation of glycohemoglobin and adiposity to atherosclerosis in youth. Pathological Determinants of Atherosclerosis in Youth (PADY) Research Group. Arterioscler ThrombVasc Biol. 1995;15(4):431–440.

21. Rajmohan L,et al. Association between isolated hypercholesterolemia, isolated hypertriglycerideia and coronary artery disease in South Indian type 2 diabetic patients. Indian Heart J. 2000;52(4):400–406.

22. Shapiro, L.M., Leatherdale, BA, Mackinnon, J; Fletcher, R.F. • Left Ventricular function in diabetes mellitus.II relation between clinical features and left ventricular function.Br Heart J, 1981, Vol. 45, P 129 - 32.

23. Shapiro IX,N,, Leatherdale, B.A. ; Coyne , M. E. et al . Prospective study of heart disease in untreated maturity onset diabetics.Br Heart J. 1982, 47 :439-44,

24. Bouchard, A., :Nancy Sanz, MD, et al. : Noninvasive Assessment of Cardiomyopathy in normotensive diabetic patients between 20 & 50 years old. The Am. J. of Medicine, 1989, Vol. 87, P 160.

25. Abenavoli, T.,:Rubler, S. et^-al, Exercise Testing vvith Myocardial Scintigraphyj.n a symptomatic Diabetic Males. Circulation, 1981, Vol., 63, P 54.

26. Inoguchi T, Yamashita T, Umeda F, Mihara H, Nakagaki O, Takada K, Kawano T, Murao H, Doi T, Nawata H. High incidence of silent myocardial ischemia in elderly patients with non insulin-dependent diabetes mellitus. Diabetes Res Clin Pract. 2000 Jan;47(1):37-44.PMID: 10660219

27. Zoneraich S. Left ventricular diastolic dysfunction evaluated by Doppler echocardiography in patients with diabetes mellitus. Am J Cardiol. 1989 Nov 1;64(16):1037-8. PubMed PMID: 2816735.

28. Sasaki A, Oikawa S, Toyota T. Microalbuminuria is closely related to diabetic macroangiopathy. Diabetes Res Clin Pract. 1999 Apr;44(1):35-40. PubMed PMID: 10414938.

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