Comparison of left ventricular mass in normotensive type 2 diabetes mellitus patients with that in the nondiabetic population

Santra, Sukamal; Basu, Avik; Roychowdhury, P.; Banerjee, Ramtanu; Singhania, Pankaj; Singh, Shivangi; Datta, Utpal

doi:10.4103/0975-3583.78597

Cited by 34 publications

(31 citation statements)

References 13 publications

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“…LVH is heavily overrepresented in patients with diabetes [19,23] and the existence of a specific diabetic cardiomyopathy has been an ongoing debate over the past decades [24]. It is likely to presume that the “harmful” diabetic phenotype overrides the cardioprotective and/or the blood pressure lowering effects of the minor allele of rs5068 .…”

Section: Discussionmentioning

confidence: 99%

A genetic variant of the atrial natriuretic peptide gene is associated with left ventricular hypertrophy in a non-diabetic population – the Malmö preventive project study

et al. 2013

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BackgroundEpidemiological studies have shown considerable heritability of blood pressure, thus suggesting a role for genetic factors. Previous studies have shown an association of a single nucleotide polymorphism rs5068 in the NPPA locus gene with higher levels of circulating atrial natriuretic peptide as well as with lower intra individual blood pressure, but up to date, no association between rs5068 and cardiac organ damage, i.e. left ventricular hypertrophy, has been accounted for in humans. We sought to explore if rs5068 is associated with left ventricular hypertrophy as measured by echocardiographic examination in a non-diabetic population.Methods968 non-diabetic individuals from the Malmö Preventive Project (mean age 67 years; 31% women) were genotyped and examined with echocardiography. Logistic regression was used to adjust for covariates.ResultsThe minor allele of rs5068 was associated with decreased prevalence of left ventricular hypertrophy (p = 0.021) after adjustment for sex and age. In the multivariate logistic analysis including; age, sex, systolic blood pressure, antihypertensive and/or cardioprotective treatment, body mass index and fasting plasma glucose, the association of rs5068 with left ventricular hypertrophy was, as expected, attenuated (p = 0.061).ConclusionIn a non-diabetic population, the minor allele of rs5068 was associated with lower left ventricular mass. These findings suggest that rs5068, or genetic variants in linkage disequilibrium, might affect susceptibility to left ventricular hypertrophy and support the possible protective role of natriuretic peptides.

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Section: Discussionmentioning

confidence: 99%

A genetic variant of the atrial natriuretic peptide gene is associated with left ventricular hypertrophy in a non-diabetic population – the Malmö preventive project study

et al. 2013

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“…Santra et al in 135 normotensive individuals, half with DM and half healthy, reported higher LV mass in DM patients compared to controls [20]. In the Framingham Heart Study, increased LV mass and wall thickness was independently associated with DM, although in multivariable analysis, significance was reached only in females [21].…”

Section: Discussionmentioning

confidence: 99%

Silent diabetic cardiomyopathy in everyday practice: a clinical and echocardiographic study

Lončarević¹,

Trifunović

Soldatović

et al. 2016

BMC Cardiovasc Disord

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BackgroundWhether type 2 diabetes mellitus (DM) in the absence of hypertension (HTA) and coronary artery disease (CAD) affects left ventricular (LV) phenotype and function among asymptomatic DM patients that can be easily discovered in everyday practice, what is the clinical risk profile for diabetic cardiomyopathy and how HTA and CAD modulate LV structure and function above diabetic cardiomyopathy, are still incompletely answered questions.MethodsIn 210 DM patients (group I: 70 asymptomatic DM patients without HTA and CAD; group II: 70 DM patients with HTA and no CAD; group III: 70 DM patients with CAD and no HTA) and 80 healthy individuals, comprehensive echocardiography including speckle tracking strain and strain rate analysis, was done.ResultsCompared to control DM patients without HTA and CAD had increased LV mass, more frequently concentric remodeling, impaired LV relaxation and lower LV ejection fraction (EF), fraction of shortening (FS) and mitral annular plane excursion (MAPSE). Addition of HTA further impaired EF, FS and MAPSE and aggravated diastolic dysfunction, whereas concomitant CAD further impaired FS and MAPSE. Peak global longitudinal strain (Slong) and early diastolic longitudinal strain rate (SRlong E) were impaired in group I compared to control, even when EF was preserved. Peak circumferential strain (Scirc) was impaired only when DM was associated with HTA or CAD. In multivariate analysis DM was significantly and independently from HTA, CAD, age, gender and body mass index associated with: increased LV mass, concentric LV remodeling, lower EF, FS, MAPSE, Slong, SRlongE and distorted diastolic parameters. DM duration, glycosylated hemoglobin, microalbuminuria and retinopathy, were not independent predictors of LV geometry and function.ConclusionDM per se has strong and independent influence on LV phenotype and function that can be detected by conventional and speckle tracking echocardiography in everyday clinical practice, even in asymptomatic patients. We could not confirm that these changes were independently related to duration of DM, quality of metabolic control and presence of microvascular complications. Concomitant HTA or CAD furthermore distorted LV systolic and diastolic function.

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“…En la literatura biomédica existen escasos estudios sobre HVI en pacientes diabéticos en ausencia de HTA (12) . En el trabajo de Dawson et al (3) el 61% de diabéticos tuvieron HTA y en el estudio de Framingham (13) se encontró HVI en el 28% de mujeres sobre los 60 años con presiones arteriales sistólicas mayores de 125-139 mmHg.…”

Section: Discussionunclassified

“…Por ello cobran especial interés las investigaciones que tienen como objetivo estudiar la relación existente entre la HVI y la DM en ausencia de otros factores cardiovasculares; en este trabajo se encontró una frecuencia de 63,7% de HVI en pacientes diabéticos sin antecedentes de causas definidas para esta enfermedad; valor que coincide con otros estudios que informan porcentajes similares en diferentes poblaciones (12,13,15) ; lo cual refuerza la hipótesis planteada. Esta investigación sugiere, además, que los adultos mayores del sexo femenino que padecen de DM son el grupo de riesgo más vulnerable a desarrollar HVI, tal como lo sugieren otros estudios (16,17) .…”

Section: Discussionunclassified

Prevalencia de hipertrofia ventricular izquierda en pacientes diabéticos

Valarezo-Sevilla¹,

Pazmiño-Martinez²,

Morales-Mora³

2014

Rev Peru Med Exp Salud Publica

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RESUMENCon el objetivo de establecer la prevalencia de hipertrofia ventricular izquierda (HVI) en pacientes con diabetes mellitus tipo 2 (DM), se realizó un estudio transversal en estos pacientes, estableciendo sus características antropométricas, presión arterial y control metabólico. Para evaluar la presencia de HVI se empleó ecocardiografía transtorácica. El estudio incluyó 91 pacientes, en los cuales la prevalencia de HVI fue de 63,7%, siendo más frecuente en mujeres que en varones (p=0,001). Adicionalmente, se encontró un 46,2% de pacientes con disfunción diastólica del ventrículo izquierdo. Se concluye que existe una importante prevalencia de HVI en pacientes diabéticos sin antecedentes de causas definidas de hipertrofia. No se encontró relación con sexo, control metabólico, IMC y tiempo de diagnóstico. ABSTRACTIn order to establish the prevalence of left ventricular hypertrophy (LVH) in patients with type 2 diabetes mellitus, (DM) a cross-sectional study was conducted in these patients studying their anthropometric characteristics, blood pressure and metabolic control. To evaluate the presence of LVH, a trans-thoracic echocardiogram was used. The study included 91 patients, finding a 63.7% prevalence of HVI, with women being more affected than men (p=0.001). Additionally, 46.2% of patients were found to have diastolic dysfunction of the left ventricle. We conclude that there is an important prevalence of LVH in diabetic patients without defined causes of hypertrophy. There was no association with sex, metabolic control, BMI and time of diagnosis.

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Comparison of left ventricular mass in normotensive type 2 diabetes mellitus patients with that in the nondiabetic population

Cited by 34 publications

References 13 publications

A genetic variant of the atrial natriuretic peptide gene is associated with left ventricular hypertrophy in a non-diabetic population – the Malmö preventive project study

A genetic variant of the atrial natriuretic peptide gene is associated with left ventricular hypertrophy in a non-diabetic population – the Malmö preventive project study

Silent diabetic cardiomyopathy in everyday practice: a clinical and echocardiographic study

Prevalencia de hipertrofia ventricular izquierda en pacientes diabéticos

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