971-P: Prevalence of Diabetic Cardiomyopathy in Real-World Practice: A Longitudinal Cohort Study

Abstract

Background: Diabetic Cardiomyopathy (DbCM) is a form of Stage B heart failure (HF) which results from diabetes-associated metabolic alterations. The prevalence of DbCM in patients with type 2 diabetes (T2D) is not well established. This study aims to evaluate prevalence of DbCM in T2D patients that have had transthoracic echocardiograms (TTE) at the UC San Diego Medical Center. Methods: Retrospective review of medical records of patients with confirmed T2D who had TTE within 2010-2015 performed. DbCM was diagnosed in patients without overt HF based on echocardiographic demonstration of left ventricular (LV) dysfunction (LVD) defined as LV ejection fraction (LVEF) ≥45% and left atrial volume index (LAVI) ≥34 mL/m2, while excluding other medical conditions which can contribute to LVD and TTE findings. Results: In total, 6570 T2D patients with TTE were identified and 5959 (91%) had LVEF≥45%. Of them, 1868 patients (31%) had LAVI≥34 mL/m2, thus met criteria for LVD suggesting diagnosis of DbCM. After excluding patients with comorbidities such as hypertension (42% of excluded patients), coronary artery disease (38%), and valvular heart disease (24%), 165 patients (9% of patients with LVD; 3% of T2D patients with TTE) met criteria for DbCM associated solely with T2D. LV hypertrophy was found in 70% of patients with DbCM. Conclusion: The majority of T2D patients (~91%) had preserved LV systolic function, of which at least ~31% had initial diagnosis of DbCM. The conservative estimation of the prevalence of DbCM indicates that at least ~9% of patients from this group had DbCM associated solely with T2D. However, this is an underestimation as only patients who had TTE were included and LAVI was the only initial criteria used to stratify the patients. If other criteria such as elevated E/E’ or LV hypertrophy were included we estimate the prevalence to be significantly higher. Therapies that target metabolic derangement responsible for DbCM can be useful in treating T2D patients to prevent progression to overt HF. Disclosure I. Swiatkiewicz: None. N. T. Patel: None. P. R. Taub: Consultant; Self; Amgen Inc., Bayer Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk, Sanofi, Other Relationship; Self; Applied Therapeutics. Funding Applied Therapeutics