OP12: Association between retinopathy and early echographic markers of cardiomyopathy in type 2 diabetes

Abstract

Background and aims Alterations in cardiac structure and function occur in type 2 diabetes independently of coronary artery disease or hypertension. The underlying mechanisms remain unclear. The aim of our study was to explore the putative involvement of microangipathy in the determinism of cardiac myocardiopathy. Materials and Methods 387 patients with type 2 diabetes mellitus (D2) with controlled blood pressure and without overt valvular or coronary heart disease were prospectively enrolled. All subjects underwent comprehensive echocardiography, including evaluation of diastolic and systolic LV function by conventional assessment and use of speckle-tracking imaging. Diastolic dysfunction was defined by left atrium area (adjusted for body surface area) > 11 cm2/m2 and/or lateral E’ -18%. Diabetic retinopathy assessed by ETDRS criteria was graded in 3 stages 0: no retinopathy, 1: mild non proliferative retinopathy, 2: moderate, severe non proliferative and proliferative retinopathy. Results 191(57.2%) patients exhibited diastolic dysfunction vs 143 (42.8%) who had no dysfunction. By univariate analysis: diastolic dysfunction was associated with diabetic retinopathy (p=0.01), additionally these patients were more likely to be female (M/F 95/96 vs 88/55, p=0.02), were older (60±8 vs 55±8, p 83 (26%) patients only had systolic dysfunction vs 236 (74%) who no had dysfunction. By univariate analysis: presence of subclinical LV systolic dysfunction in diabetic patients was associated with a higher prevalence of diabetic retinopathy (p =0.04), additionally these patients were more likely to be male (M/F 58/32 vs 125/118, p=0.03), to have obesity BMI (31±5 vs30±4, p=0.02), with higher SPB (138±15 vs 132±16, p =0.001), and lower HDL (1.2±0.3 vs 1.3±0.4, p=0.03). Microalbuminuria was not different in both groups, p=0.3. By multivariable analysis, factors independently associated with diastolic dysfunction were age (OR(95%)=1.09 [1.05–1.12], p Conclusion In our cohort of type 2 diabetic patients, only retinopathy was found associated with the commonly reported diastolic dysfunction whereas retinopathy was not found independently associated with systolic dysfunction.