“A Study of Left Ventricular Diastolic Function in Type-2 Diabetic Patients”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
BACKGROUND: - Patients with diabetes mellitus have high cardiovascular morbidity and mortality. Left ventricular diastolic dysfunction, a basic characteristic of diabetic heart disease (diabetic cardiomyopathy), appears before the development of systolic dysfunction, suggesting that diastolic markers might be sensitive for early cardiac injury. AIMS :-To study left ventricular diastolic function in diabetic patients by echocardiographic measures and its correlation withAge, BMI,HbA1C, duration of diabetes, diabetic retinopathy ,microalbuminuria .METHODS: The present study was a hospital based case control study conducted in the Department of General Medicine, GR Medical College Gwalior, from January 2016 to September 2017 with a total of 90 subjects {divided in to case (n=60) and control (n=30)}.All subjects had undergone a standard 12 lead ECG and Doppler 2D- Echo with pulsed Doppler imaging in addition to routine anthropometric and biochemical measurementsStatistical Analysis: All the data analysis was done using IBMSPSS version 20 software. Data is expressed as percentage and mean ± SD. Student t test and analysis of variance was used to tabulate the data. P value of <0.05 is considered as significant. RESULTS: Onechocardiographic evaluation, Left Ventricular Diastolic Dysfunction (LVDD) was recorded in 32 (53.3%) of the patients in Case and 2 (6.7%) of control group.Among cases out of 32 (53.3%) having LVDD, 24 (40%) patients had Impaired Relaxation, 5 (8.3%) Pseudo-Normalization and 3 (5%) had Restrictive Filling. Diastolic dysfunction was highest in patients age group 51-60yrs,57.89% compared to 45.45% in age group 40-50yrs. In patients who had HbA1C >7.5,75% developed diastolic dysfunction. In patients with BMI >30,60% developed diastolic dysfunction. Among cases, in Duration of DM <2 and 2-5 years, 2 (16.67%) and 30 (62.5%) had LVDD respectively. Among cases, patients with Diabetic Retinopathy (DR), 83.33% had LVDD. Among cases, patients withmicro albuminuria,87.9% had LVDD .Cases with Total Cholesterol (TC) > 200 mg/dl, 63.63% had LVDD. Among cases, in patients with TG >150mg/dl, 70% had LVDD.CONCLUSION: This study has shown that interaction of type 2 diabetics with left ventricular diastolic dysfunction .Older age, high BMI, prolonged duration of diabetes,HbA1C>7.5%,diabetic retinopathy, micro albuminuria hypercholesterolemia, hypertriglyceridemia had a higher prevalence of LVDD and thus this is an indicator of early diabetic cardiomyopathy. Early diagnosis and institution of treatment for LVDD in diabetic patients will reduce the morbidity and improve the outcomes by preventing future development of heart failure.
Authors and Affiliations
Singhal P1, Rawat Ram A. 2 ,, Jatav O. P. 1, Arya D. 1
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