Left ventricular dysfunction and outcome at two-year follow-up in patients with type 2 diabetes: The DYDA study

Giovanni Cioffi, Pompilio Faggiano, Donata Lucci, Aldo P. Maggioni, Valeria Manicardi, Augusto Travaglini, Daniela Girfoglio, Serge Masson, Carlo B. Giorda, Mario Velussi, Andrea Di Lenarda, Paolo Verdecchia, Marco Comaschi

Research output: Contribution to journalArticle

Abstract

Aims: Left ventricular dysfunction (LVD) in type 2 diabetes mellitus (DM) (DYDA) study is a prospective investigation enrolling 960 with DM without overt cardiac disease. At baseline, a high prevalence of LVD was detected by analysing midwall shortening. We report here the incidence of clinical events in DYDA patients after 2-year follow-up and the frequency of LVD detected at baseline and 2-year evaluation. Methods: Systolic LVD was defined as midwall shortening ≤15%, diastolic LVD as any condition different from "normal diastolic function" identified as E/A ratio on Doppler mitral flow between 0.75 and 1.5 and deceleration time of E wave >140. ms. Major outcome was a composite of major events, including all-causes death and hospital admissions. Results: During the study period, any systolic/diastolic LVD was found in 616 of 699 patients (88.1%) in whom LVD function could be measured at baseline or at 2 years. Older age and high HbA1c predicted the occurrence of LVD. During the follow-up 15 patients died (1.6%), 3 for cardiovascular causes, 139 were hospitalized (14.5%, 43 of them for cardiovascular causes, 20 for a new cancer). Conclusions: During a 2-year follow-up any LVD is detectable in a large majority of patients with DM without overt cardiac disease. Older age and higher HbA1c predict LVD. All-cause death or hospitalization occurred in 15% of patients, cardiovascular cause was uncommon. Independent predictors of events were older age, pathologic lipid profile, high HbA1c, claudicatio and repaglinide therapy. Echo-assessed LVD at baseline was not prognosticator of events.

Original languageEnglish
Pages (from-to)236-242
Number of pages7
JournalDiabetes Research and Clinical Practice
Volume101
Issue number2
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Diastolic function
  • Heart failure
  • Left ventricular dysfunction
  • Systolic function
  • Type 2 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Endocrinology

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    Cioffi, G., Faggiano, P., Lucci, D., Maggioni, A. P., Manicardi, V., Travaglini, A., Girfoglio, D., Masson, S., Giorda, C. B., Velussi, M., Di Lenarda, A., Verdecchia, P., & Comaschi, M. (2013). Left ventricular dysfunction and outcome at two-year follow-up in patients with type 2 diabetes: The DYDA study. Diabetes Research and Clinical Practice, 101(2), 236-242. https://doi.org/10.1016/j.diabres.2013.05.010