Heart failure in <scp>SAVOR‐TIMI</scp> 53: The hindsight of diabetic retinopathySAVOR‐TIMI 53研究中的心脏衰竭：糖尿病视网膜病变的后尘

Gilbert, Richard E.

doi:10.1111/1753-0407.12249

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“…Patients with T2DM complicated by retinopathy is common and is closely associated with glycemic control [ 23 – 25 ]. In addition, the presence of retinopathy has been shown to have adverse effects on LV remodeling and myocardial function that may contribute to an increased incidence of heart failure [ 26 ]. In the Multi-Ethnic Study of Atherosclerosis (MESA), narrowing of the retinal arteriolar caliber was associated with LV concentric hypertrophy as determined by cardiac magnetic resonance imaging [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Altered myocardial response in patients with diabetic retinopathy: an exercise echocardiography study

Zhen

Chen

Shih

et al. 2015

Cardiovasc Diabetol

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BackgroundType 2 diabetes mellitus (T2DM) complicated by retinopathy is associated with altered left ventricular (LV) structure and resting myocardial dysfunction unlike T2DM without retinopathy. The myocardial response to stress has not been compared in patients with and without diabetic retinopathy. The aim of this retrospective study was to determine the relationship between retinopathy and myocardial function in patients with T2DM at rest and during exercise echocardiography.Methods134 patients with T2DM and no evidence of underlying coronary artery disease were recruited. All patients underwent retinal photography to screen for diabetic retinopathy, and resting and exercise echocardiography. Resting echocardiography was analyzed by conventional echocardiographic parameters and speckle tracking derived global longitudinal strain (GLS). Exercise echocardiography parameters included diastolic function reserve index (DFRI) and stress GLS.ResultsThe mean age of participants was 60 years and 49 % were male. Diabetic retinopathy was identified in 43 patients (32 %). Resting echocardiography revealed that those with diabetic retinopathy had a higher prevalence of impaired diastolic function, higher E/E′ ratio (LV filling pressures) and impaired resting GLS compared with those without. Exercise echocardiography revealed that those with diabetic retinopathy also had more impaired DFRI and stress GLS. Multivariable analysis showed that the presence of diabetic retinopathy was independently associated with high resting E/E′, diastolic dysfunction grade, impaired resting GLS, low DFRI and impaired stress GLS.ConclusionsIn conclusion, the presence of diabetic retinopathy was independently associated with impaired resting myocardial function (diastolic and systolic function) and myocardial function during stress (evaluated by DFRI and stress GLS).Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-015-0281-5) contains supplementary material, which is available to authorized users.

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