The aim of the present study was to determine the prevalence and predictors of an abnormal echocardiogram in patients with Type 2 diabetes. Cardiac function and structure were rigorously assessed by comprehensive transthoracic echocardiographic techniques in 229 patients with Type 2 diabetes. Cardiovascular risk factors and diabetic complications were assessed, and predictors of an abnormal echocardiogram were identified using multivariate logistic regression analysis. An abnormal echocardiogram was present in 166 patients (72%). LVH (left ventricular hypertrophy) occurred in 116 patients (51%), and cardiac dysfunction was found in 146 patients (64%), of whom 109 had diastolic dysfunction alone and 37 had systolic±diastolic dysfunction. Independent predictors of an abnormal echocardiogram were obesity, age, the number of antihypertensive drugs used (all P<0.001) and creatinine clearance (P<0.05). The risk of an abnormal echocardiogram increased by 9% for each year over 50 years of age {OR (odds ratio), 1.09 [95% CI (confidence interval), 1.04–1.15]}, 3-fold if obesity was present [BMI (body mass index) >30; OR, 4.2 (95% CI, 1.9–9.0)] and by 80% for each antihypertensive agent used [OR, 1.8 (95% CI, 1.3–2.4) per agent]. In conclusion, an abnormal cardiac echocardiogram is common in patients with Type 2 diabetes. Importantly, although cardiac abnormalities can be predicted by traditional risk factors, such as age, obesity and renal function, the absence of micro- or macro-vascular complications does not predict a normal echocardiogram. We suggest that an echocardiogram identifies those with Type 2 diabetes at increased cardiovascular risk due to occult LVH and diastolic dysfunction, and this information may lead to more aggressive management of known risk factors in the clinic.
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February 2008
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Research Article|
January 15 2008
Prevalence and predictors of cardiac hypertrophy and dysfunction in patients with Type 2 diabetes
Piyush M. Srivastava;
Piyush M. Srivastava
*Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3081, Australia
†Department of Cardiology, Austin Health, Heidelberg, Victoria 3081, Australia
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Paul Calafiore;
Paul Calafiore
†Department of Cardiology, Austin Health, Heidelberg, Victoria 3081, Australia
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Richard J. Macisaac;
Richard J. Macisaac
*Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3081, Australia
‡Endocrine Unit, Austin Health, Heidelberg Repatriation Hospital, Heidelberg, Victoria 3081
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Sheila K. Patel;
Sheila K. Patel
*Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3081, Australia
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Merlin C. Thomas;
Merlin C. Thomas
*Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3081, Australia
§Baker Heart Research Institute, Melbourne, Victoria 8008, Australia
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George Jerums;
George Jerums
*Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3081, Australia
‡Endocrine Unit, Austin Health, Heidelberg Repatriation Hospital, Heidelberg, Victoria 3081
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Louise M. Burrell
*Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3081, Australia
Correspondence: Professor Louise M. Burrell (email [email protected]).
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Publisher: Portland Press Ltd
Received:
July 30 2007
Revision Received:
October 03 2007
Accepted:
October 05 2007
Accepted Manuscript online:
October 05 2007
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2008 Biochemical Society
2008
Clin Sci (Lond) (2008) 114 (4): 313–320.
Article history
Received:
July 30 2007
Revision Received:
October 03 2007
Accepted:
October 05 2007
Accepted Manuscript online:
October 05 2007
Citation
Piyush M. Srivastava, Paul Calafiore, Richard J. Macisaac, Sheila K. Patel, Merlin C. Thomas, George Jerums, Louise M. Burrell; Prevalence and predictors of cardiac hypertrophy and dysfunction in patients with Type 2 diabetes. Clin Sci (Lond) 1 February 2008; 114 (4): 313–320. doi: https://doi.org/10.1042/CS20070261
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