Left ventricular diastolic dysfunction in normotensive postmenopausal women with type 2 diabetes mellitus

Maiello, Maria; Zito, Annapaola; Cecere, Annagrazia; Ciccone, Marco Matteo; Palmiero, Pasquale

doi:10.5603/cj.a2016.0064

Cited by 18 publications

(9 citation statements)

References 26 publications

(31 reference statements)

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“…Many studies have confirmed that 90% of patients with T2DM, but without evidence of CVDs, have left diastolic dysfunction [21,25,26], supporting the heart function results observed in this study. Indeed, significant differences were observed between the T2DM and control groups in IVST, LVEDD, Dd, LVM, and left atrial diameter.…”

Section: E918972-4supporting

confidence: 90%

Echocardiographic Changes in Newly Diagnosed Type 2 Diabetes Mellitus Patients with and without Hypertension

Zhao

Hou

et al. 2020

Med Sci Monit

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Departmental sources Background: Whether type 2 diabetes mellitus (T2DM) is independently associated with structural heart abnormalities is controversial because of confounders associated with T2DM. This study aimed to investigate echocardiographic features in patients with newly diagnosed T2DM, exploring changes in cardiac structure and function. Material/Methods: This was a retrospective study of new T2DM cases treated at the Second People's Hospital Affiliated to Nanjing Medical University (Changzhou) in 2014-2016. In all, 128 T2DM cases were included (62 hypertensive and 66 non-hypertensive individuals). Controls were selected among individuals who underwent examination at the same department/period. Interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDD), posterior left ventricular wall thickness (PWTD), left ventricle mass (LVM), end-diastolic thickness of left ventricular posterior wall (Dd), aortic root diameter, left atrial diameter (LAd), left atrial diameter fraction-shortening values, and left ventricular ejection fraction (LVEF) were determined routinely. Results: IVST, LVEDD, PWTD, Dd, LAd, and left atrial diameter fraction-shortening values were larger in patients with T2DM (all P<0.05 vs. controls). LVM was higher in T2DM patients (median, 57.12 vs. 54.77 g, P=0.001). There were no differences in aortic root diameter and EF (both P>0.05). Multivariable analysis showed that IVST (OR=1.33, 95% CI: 1.01-1.76, P=0.04), LAd (OR=1.16, 95% CI: 1.07-1.25, P<0.001), TGs (OR=1.34, 95% CI: 1.09-1.63, P=0.005), and HDL (OR=1.46, 95% CI: 1.02-2.08, P=0.04) were independently associated with hypertension in patients with T2DM. Conclusions: Patients with newly diagnosed T2DM already display structural heart abnormalities. LAd and IVST are independently associated with hypertension in these patients, probably contributing to increased cardiovascular risk.

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Section: E918972-4supporting

confidence: 90%

Echocardiographic Changes in Newly Diagnosed Type 2 Diabetes Mellitus Patients with and without Hypertension

Zhao

Hou

et al. 2020

Med Sci Monit

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“…[ 35 ] Therefore, early diagnosis and treatment of LVDD might be useful to reduce morbidity and improve the outcomes. [ 36 ] LVDD refers to mechanical and functional abnormalities during relaxation and filling of the ventricle. Hence, LV diastolic filling might be abnormal even in the absence of LV hypertrophy and might represent an early marker of hypertension-related heart disease in EH.…”

Section: Discussionmentioning

confidence: 99%

“…[ 45 ] These findings could be easily explained by increased aortic stiffness and high peripheral resistance, which compromised LV diastolic function in postmenopausal women. [ 36 ] Each of these processes was associated with obesity, diabetes, renal disease, and EH, which are all diseases characterized by reductions in myocardial relaxation and LV compliance. [ 35 ] In addition, there are other determinants of LVDD.…”

Section: Discussionmentioning

confidence: 99%

Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome

et al. 2018

Chinese Medical Journal

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Background:Postmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS.Methods:This was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis.Results:A total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E’; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E’ to the late diastolic mitral annular velocity (E’/A’; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E’ (E/E’; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E’ (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E’/A’ (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E’ (r = 0.472; P = 0.003) and E’/A’ (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E’ (r = −0.590; P < 0.001), E/E’ (r = 0.454; P = 0.004), and E’/A’ (r = −0.377; P = 0.018).Conclusions:Conventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD.Chinese Clinical Trial Register:ChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.

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“…Abundant of studies have showed that T2DM was related to various target organ damage and elevated risk of cardiovascular events [19–21]. In addition, previous studies suggested that T2DM was associated with minute LV systolic and diastolic dysfunction, which might further lead to the progression of diabetic cardiomyopathy [20, 22–25]. T2DM patients with suboptimal glycemic control have increased aortic stiffness and a higher prevalence of LV hypertrophy, along with lower diastolic and systolic LV longitudinal performance [26].…”

Section: Discussionmentioning

confidence: 99%

Visit-to-visit fasting plasma glucose variability is an important risk factor for long-term changes in left cardiac structure and function in patients with type 2 diabetes

Tang

Zhong

Zhang

et al. 2019

Cardiovasc Diabetol

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Background To investigate the effect of visit-to-visit fasting plasma glucose (FPG) variability on the left cardiac structure and function in patients with type 2 diabetes mellitus (T2DM). Methods In this prospective cohort study, 455 T2DM patients were included and follow-up for a median of 4.7 years. FPG measured on every hospital visit was collected. FPG variability was calculated by its coefficient of variation (CV-FPG). Left cardiac structure and function were assessed using echocardiography at baseline and after follow-up. Multivariable linear regression analyses were used to estimate the effect of FPG variability on the annualized changes in left cardiac structure and function. Subgroup analysis stratified by mean HbA1c levels (< 7% and ≥ 7%) were also performed. Result In multivariable regression analyses, CV-FPG was independently associated with the annualized changes in left ventricle (β = 0.137; P = 0.031), interventricular septum (β = 0.215; P = 0.001), left ventricular posterior wall thickness (β = 0.129; P = 0.048), left ventricular mass index (β = 0.227; P < 0.001), and left ventricular ejection fraction (β = − 0.132; P = 0.030). After additionally stratified by mean HbA1c levels, CV-FPG was still independently associated with the annualized changes in the above parameters in patients with HbA1c ≥ 7%, while not in patients with HbA1c < 7%. Conclusions Visit-to-visit variability in FPG could be a novel risk factor for the long-term adverse changes in left cardiac structure and systolic function in patients with type 2 diabetes. Trial registration ClinicalTrials.gov (NCT02587741), October 27, 2015, retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s12933-019-0854-9) contains supplementary material, which is available to authorized users.

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Left ventricular diastolic dysfunction in normotensive postmenopausal women with type 2 diabetes mellitus

Abstract: (Cardiol J 2017; 24, 1: 51-56)

Cited by 18 publications

References 26 publications

Echocardiographic Changes in Newly Diagnosed Type 2 Diabetes Mellitus Patients with and without Hypertension

Echocardiographic Changes in Newly Diagnosed Type 2 Diabetes Mellitus Patients with and without Hypertension

Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome

Visit-to-visit fasting plasma glucose variability is an important risk factor for long-term changes in left cardiac structure and function in patients with type 2 diabetes

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