Observational study investigating the prevalence of asymptomatic stage B heart failure in patients with type 2 diabetes who are not known to have coronary artery disease.

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  • Additional Information
    • Source:
      Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
    • Subject Terms:
      Coronary Artery Disease/*epidemiology ; Diabetes Mellitus, Type 2/*epidemiology ; Heart Failure/*epidemiology; Cardiomyopathies/epidemiology ; Diabetes Mellitus, Type 2/complications ; Echocardiography ; Female ; Heart Failure/diagnostic imaging ; Humans ; Hypertension/epidemiology ; Malaysia/epidemiology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Stroke Volume ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/epidemiology ; Ventricular Function, Left
    • Abstract:
      Objective: To identify the prevalence of stage B heart failure (SBHF) in patients with type 2 diabetes mellitus (T2DM) with no history of cardiovascular disease (CVD).
      Design: Observational study.
      Setting: A single-centre study in which eligible patients were recruited from T2DM clinic. Following consent, patients completed a questionnaire and underwent physical examinations. Patients had blood drawn for laboratory investigations and had a transthoracic echocardiography.
      Participants: A total of 305 patients who were not known to have CVD were recruited. Patients with deranged liver function tests and end stage renal failure were excluded.
      Main Outcome Measures: Echocardiographic parameters such as left ventricular ejection fraction, left ventricular mass index (LVMI), left ventricular hypertrophy, left atrial enlargement and diastolic function were examined.
      Results: A total of 305 patients predominantly females (65%), with mean body mass index of 27.5 kg/m 2 participated in this study. None of them had either a history or signs and symptoms of CVD. Seventy-seven percent of patients had a history of hypertension and 83% of this study population had T2DM for more than 10 years. Mean HbA1c of 8.3% was recorded. Almost all patients were taking metformin. Approximately, 40% of patients were on newer anti-T2DM agents such as sodium-glucose cotransporter-2 and dipeptidyl peptidase 4 inhibitors. Fifty-seven percent (n=174) of the study population had SBHF at the time of study: diastolic dysfunction, increased LVMI and increased left atrial volume index (LAVI) were noted in 51 patients (17%), 128 patients (42%) and 98 patients (32%), respectively. Thirty-seven patients (12%) had both increase LVMI and LAVI.
      Conclusion: Our study has revealed a high prevalence of SBHF in T2DM patients without overt cardiac disease in Malaysia that has one of the highest prevalence of TDM in the world.
      Competing Interests: Competing interests: None declared.
      (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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    • Contributed Indexing:
      Keywords: cardiomyopathy; echocardiography; general diabetes; heart failure; hypertension
    • Publication Date:
      Date Created: 20210122 Date Completed: 20210419 Latest Revision: 20210419
    • Publication Date:
      20221213
    • Accession Number:
      PMC7825254
    • Accession Number:
      10.1136/bmjopen-2020-039869
    • Accession Number:
      33478961