Abnormal echocardiography in patients with type 2 diabetes and relation to symptoms and clinical characteristics

Abstract

Objectives: We aimed to determine the prevalence of echocardiographic abnormalities and their relation to clinical characteristics and cardiac symptoms in a large, contemporary cohort of patients with type 2 diabetes. Results: A total of 1030 patients with type 2 diabetes participated. Echocardiographic abnormalities were present in 513 (49.8%) patients, mainly driven by a high prevalence of diastolic dysfunction 178 (19.4%), left ventricular hypertrophy 213 (21.0%) and left atrial enlargement, 200 (19.6%). The prevalence increased markedly with age from 31.1% in the youngest group (<55 years) to 73.9% in the oldest group (>75 years) (p < 0.001) and was equally distributed among the sexes (p = 0.76). In univariate analyses, electrocardiographic abnormalities, age, body mass index, known coronary heart disease, hypertension, albuminuria, diabetes duration and creatinine were associated with abnormal echocardiography along with dyspnoea and characteristic chest pain (p < 0.05 for all). Neither of the cardiac symptoms nor clinical characteristics had sufficient sensitivity and specificity to accurately identify patients with abnormal echocardiography. Conclusion: Echocardiographic abnormalities are very common in outpatients with type 2 diabetes, but neither cardiac symptoms nor clinical characteristics are effective to identify patients with echocardiographic abnormalities.

Prevalence of heart failure and the diagnostic value of MR‐proANP in outpatients with type 2 diabetes

“…Patients are referred to these clinics because of inadequate glycaemic control or diabetes‐related complications, and treatment is intensified with a multidisciplinary approach. All patients in the clinics were eligible to participate in the Thousand&2 Study . A total of 1030 patients (participation rate, 47.8%) were included.…”

“…All patients in the clinics were eligible to participate in the Thousand&2 Study. 8 A total of 1030 patients (participation rate, 47.8%) were included. For the present analyses, 224 patients were excluded (n = 7, prior heart valve replacement; n = 21, atrial fibrillation; n = 87, missing laboratory values; n = 109, missing echocardiographic measurements).…”

Insulin treatment in heart failure patients: the good, the bad or the ugly?

“…What do we know about HFpEF in T2DM patients? In a cross‐sectional echocardiographic study in 1000 T2DM patients, risk factors for development of HFpEF were common: diastolic dysfunction (20%), left ventricular hypertrophy (20%) and left atrial enlargement (20%) . Furthermore, screening identifies undiagnosed HFpEF in 20–25% of T2DM patients .…”

Methods for Ultrasound Screening of Cardiovascular Diseases in Type 2 Diabetic Patients

“…Except for LVDD, other echocardiographic changes that can be found in type 2 diabetes patients [10,17] are left ventricle remodeling and hypertrophy [18], reduced EF [19], dilated left atrium [19], and valvular impairment [20]. These disorders could be diagnosed early in the course of the diabetes progression and often remain asymptomatic [19]. Jorgensen et al found echocardiographic abnormalities in 49,8% of 1030 outpatients with DM2 and the prevailing alterations were LV hypertrophy, dilated left atrium and LVDD [19].…”