Progression of Diastolic Dysfunction in Type II Diabetes is Associated with Blood Pressure, Weight Gain and Increasing LV Mass

Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with subclinical diastolicdysfunction (DD), but the evolution of these changes is undefined. Weinvestigated the progression and clinical correlates of DD in T2DM.Methods: 159 prospectively recruited T2DM pts (age 55±10 yrs, 45% male) underwent2D echocardiography, metabolic and clinical evaluation at baseline and1 year. Diastolic function was characterized as normal, delayed relaxation pattern,pseudonormal or restrictive. Change in diastolic categorization and tissueDoppler Em was assessed, and correlations sought with clinical and metabolicvariables using multivariate logistic regression.Results: At baseline, 104 pts (65%) had normal diastolic function, 43 pts (27%) had delayed relaxation, 11 (7%) were pseudonormal and 1 (0.6%) was restrictive.At 1 year, 50% were unchanged, 26% had progressed and 24% improved; seeTable for correlates of deterioration. Change in Em was independently correlatedwith age (p<0.02), duration of diabetes (p<0.01) and change in waist circumference(p<0.02). Correlates of deterioration in diastolic category were baselinesystolic blood pressure (SBP) (p<0.02), change in weight (p<0.05) and changein LV mass index (p<0.02). There were no significant associations with glucoselevels, HbA1C, lipids, VO2max or other clinical parameters. Conclusions: Abnormal diastolic function is common in T2DM and progressionis independently associated with higher baseline SBP, weight gain and increasingLV mass.