Left ventricular diastolic dysfunction in type II diabetes mellitus with preserved systolic function: Prevalence and associated factors

Abstract

Doppler echocardiography has largely contributed to show the existence of distinct diabetic cardiomyopathy, independent of the coexistence of concomitant risk factors. The objective of our study was to evaluate the prevalence of diastolic dysfunction in Type II diabetic patients in light of the latest 2016 recommendations of the American Society of Echocardiography and to identify its associated factors. It was a cross-sectional observational study with a descriptive and analytic focus spread over a 6-month period from July to December 2017. We studied 66 asymptomatic patients with type 2 diabetes mellitus without evidence of cardiovascular involvement, blood pressure less than 130/80 mmHg and with a maximal treadmill exercise test showing no ischemia. LVDD was evaluated by Doppler echocardiography. The mean age of our population, was 42 years ± 9 years with extremes ranging from 39 to 84 years, we noted a female predominance (68%) with a sex ratio of 2.14. The prevalence of diastolic dysfunction was 27%. Factors associated with this change in diastolic function were advanced age ( P < 0.0001), duration of diabetes > 10 years ( P < 0.0001), uncontrolled diabetes as assessed by HbA 1c levels > 7% ( P < 0), 0001) and elevated fasting glucose levels ( P = 0.039), obesity ( P < 0.0001), dyslipidemia (p <0.0001) and menopause ( P = 0.002). Diastolic dysfunction affects a significant percentage of patients with type II diabetes. Therefore, we propose strict glycemic control in those patients, an early cardiographic echo screening in subjects at-risk, in order to improve their management and to limit their progression to more serious complications.