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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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- Author(s): Oo MM;Oo MM; Tan Chung Zhen I; Tan Chung Zhen I; Ng KS; Ng KS; Tan KL; Tan KL; Tan ATB; Tan ATB; Vethakkan SR; Vethakkan SR; A/L Ratnasingam RJ; A/L Ratnasingam RJ; Chee KH; Chee KH
- Source:
BMJ open [BMJ Open] 2021 Jan 21; Vol. 11 (1), pp. e039869. Date of Electronic Publication: 2021 Jan 21.- Publication Type:
Journal Article; Observational Study- Language:
English - Source:
- 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.) - References: Lipids Health Dis. 2019 Apr 6;18(1):90. (PMID: 30954084)
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J Am Coll Cardiol. 2009 Apr 14;53(15):e1-e90. (PMID: 19358937) - 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
- Source:
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