Subclinical LV dysfunction and 10-year outcomes in type 2 diabetes mellitus

Holland, David J.; Marwick, Thomas H.; Haluska, Brian; Leano, Rodel; Hordern, Matthew D.; Hare, James L.; Fang, Zhi; Prins, Johannes B.; Stanton, Tony

doi:10.1136/heartjnl-2014-307391

Cited by 140 publications

(109 citation statements)

References 30 publications

(28 reference statements)

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“…5 This study confirmed the association of ECG markers with early systolic changes by impaired GLS, and these associations were independent of clinical measures including blood pressure, BMI, and comorbidities such as diabetes and hypertension. The potential mechanisms linking abnormal ECG markers and depressed systolic function are multiple.…”

Section: Figuresupporting

confidence: 80%

Association Between Electrocardiographic and Echocardiographic Markers of Stage B Heart Failure and Cardiovascular Outcome

Yang

Marwick

Okin

2016

Heart, Lung and Circulation

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Aims The detection of non-ischaemic (mainly hypertension, diabetes, and obesity) stage B heart failure (SBHF) may facilitate the recognition of those at risk of progression to overt HF and HF prevention. We sought the relationship of specific electrocardiographic (ECG) markers of SBHF to echocardiographic features of SBHF and their prognostic value for development of HF. The ECG markers were Cornell product (Cornell-P), P-wave terminal force in lead V1 (PTFV1), ST depression in lead V5 V6 (minSTmV5V6), and increased heart rate. Echocardiographic assessment of SBHF included left ventricular hypertrophy (LVH), impaired global longitudinal strain (GLS), and diastolic dysfunction (DD). Method and results Asymptomatic subjects ≥65 years without prior cardiac history, but with HF risks, were recruited from the local community. At baseline, they underwent clinical assessment, 12-lead ECG, and comprehensive echocardiography. New HF was assessed clinically at mean follow-up of 14 ± 4 months, and echocardiography was repeated in subjects with HF. Of the 447 study subjects (age 71 ± 5, 47% men) with SBHF, 13% had LVH, 32% impaired GLS, and 65% ≥grade I DD (10% ≥grade II DD). Forty were lost to follow-up. Clinical HF developed in 47 of 407, of whom 20% had echocardiographic LVH, 51% abnormal GLS, and 76% DD at baseline. Baseline LVH and abnormal GLS (not grade I DD) were independently associated with outcomes (clinical HF and cardiovascular death). Cornell-P and heart rate (not minSTmV5V6 nor PTFV1) were independently associated with LVH, impaired GLS, and DD. Cornell-P and minSTV5V6 (not heart rate nor PTFV1) were independently associated with outcomes. More ECG abnormalities improved sensitivity, but ECG-markers were not independent of or incremental to echocardiographic markers to predict HF in SBHF. Conclusions In this elderly study population, ECG markers showed low diagnostic sensitivity for non-ischaemic SBHF and low prognostic value for outcomes. Cornell-P and minSTmV5V6 had predictive value for outcomes in non-ischaemic SBHF independent of age, gender, and common comorbidities but were not incremental to echocardiography.

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Section: Figuresupporting

confidence: 80%

Association Between Electrocardiographic and Echocardiographic Markers of Stage B Heart Failure and Cardiovascular Outcome

Yang

Marwick

Okin

2016

Heart, Lung and Circulation

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“…Diabetes mellitus is an independent predictor for worse outcome following coronary revascularisation 25 26. In addition, the extent of revascularisation (complete vs incomplete) is also thought to be extremely important in the setting of diabetes mellitus 27 28.…”

Section: Stable Cadmentioning

confidence: 99%

Almanac 2015: coronary artery disease

Shavelle

2016

Heart

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Recent years have seen major advances in the evaluation and treatment of patients with coronary artery disease. These include assessment of novel biomarkers and imaging methods for patients at risk for coronary artery disease, care of patients with ST-segment elevation myocardial infarction, a novel device to treat medical refractory angina, use of non-statin lipid-lowering agents, a better understanding of the risks and benefits of long-term dual antiplatelet therapy and the use of the newer antiplatelet agents. This article summarises research related to coronary artery disease published in Heart in 2014 and 2015, within the context of other major cardiovascular journals.

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“…Global longitudinal strain (GLS) is a measure of the myocardial systolic deformation over the longitudinal axis 18. There is emerging evidence for the prognostic importance of this measure 19,20. It offers incremental prognostic information in the assessment of left ventricular (LV) function, particularly when the ejection fraction is near normal 21.…”

Section: Introductionmentioning

confidence: 99%

The association of night-time systolic blood pressure with ultrasound markers of subclinical cardiac and vascular disease

O’Flynn

Curtin

et al. 2017

Blood Pressure Monitoring

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Subclinical LV dysfunction and 10-year outcomes in type 2 diabetes mellitus

Abstract: Australian and New Zealand Clinical Trials Registry (ACTRN12612001178831).

Cited by 140 publications

References 30 publications

Association Between Electrocardiographic and Echocardiographic Markers of Stage B Heart Failure and Cardiovascular Outcome

Association Between Electrocardiographic and Echocardiographic Markers of Stage B Heart Failure and Cardiovascular Outcome

Almanac 2015: coronary artery disease

The association of night-time systolic blood pressure with ultrasound markers of subclinical cardiac and vascular disease

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