Predictors of early-stage left ventricular dysfunction in type 2 diabetes: Results of DYDA study

Carlo B. Giorda, Giovanni Cioffi, Giovanni De Simone, Andrea Di Lenarda, Pompilio Faggiano, Roberto Latini, Donata Lucci, Aldo P. Maggioni, Luigi Tarantini, Mario Velussi, Paolo Verdecchia, Marco Comaschi

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Abstract

Background: Better knowledge of prevalence and early-stage determinants of subclinical left ventricular dysfunction (LVD) in type 2 diabetes would be useful to design prevention strategies. The objective of the LVD in Diabetes (DYDA) study was to assess these points in patients without established cardiac disease. Method: Baseline clinical, ECG, laboratory and echocardiographic data from 751 patients (61±7 years, 59% hypertensive) recruited by 37 Italian diabetes clinics were analysed. Clinical history, life habits, laboratory data (NT-proBNP, HsCRP, HbA1c, serum glucose, lipids and creatinine, liver enzymes, microalbuminuria, glomerular filtrate) and data on microvascular complications and drug therapy were collected. Results: LVD was present in 59.9% of patients. Age (OR 1.05, 95% CI [1.02-1.07]), HbA1c (OR 1.27, 95% CI [1.09-1.49]), triglycerides (OR 1.003, 95% CI [1.001-1.006]), treatment with metformin (OR 1.62, 95% CI [1.09-2.40]) and doxazosine (OR 2.48, 95% CI [1.10-5.55]) were independent predictors of LVD. Glitazones were associated with reduced risk of diastolic dysfunction (OR 0.44, 95% CI [0.22-0.87]) whereas waist circumference and metformin were adversely associated with systolic dysfunction (OR 1.02, 95% CI [1.01-1.04] and 1.57, 95% CI [1.01-2.43], respectively). Conclusion: In asymptomatic and fairly controlled diabetic patients, age, worse HbA1c, traits of insulin resistance, such as visceral adiposity and triglycerides or treatment with metformin, and use of doxazosin indicate greater risk of LVD. Glitazones, at this stage, seem to be associated with better diastolic performance.

Original languageEnglish
Pages (from-to)415-423
Number of pages9
JournalEuropean Journal of Cardiovascular Prevention and Rehabilitation
Volume18
Issue number3
DOIs
Publication statusPublished - Jun 2011

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Keywords

  • Early stage left ventricular dysfunction
  • Predictive factors
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Epidemiology

Cite this

Giorda, C. B., Cioffi, G., De Simone, G., Di Lenarda, A., Faggiano, P., Latini, R., Lucci, D., Maggioni, A. P., Tarantini, L., Velussi, M., Verdecchia, P., & Comaschi, M. (2011). Predictors of early-stage left ventricular dysfunction in type 2 diabetes: Results of DYDA study. European Journal of Cardiovascular Prevention and Rehabilitation, 18(3), 415-423. https://doi.org/10.1177/1741826710389402