Diastolic Dysfunction in Type 2 Diabetes Mellitus Patients Presenting to Tertiary Care Hospital

Hafiz Asad Saeed; Syed Waqar Abbas; Muhammad Yasir; Syeda Fatima Zareen; Muhammad Hammad; Muhammad Usman

doi:10.51253/pafmj.v74i6.9906

Authors

Hafiz Asad Saeed Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Syed Waqar Abbas Department of Medicine, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Yasir Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Syeda Fatima Zareen Department of Medicine, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Hammad Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Usman University of Veterinary & Animal Sciences, Lahore Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i6.9906

Keywords:

Diastolic Dysfunction, Diabetes Mellitus, Left Atrial Volume Index, 2D Echocardiography.

Abstract

Objective: To study the frequency of left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus presenting to a tertiary care hospital.

Study Design: Cross sectional study.

Place and Duration of Study: Medicine Dept, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar to Aug 2022.

Methodology: Fifty-one patients between the ages of 30 to 65 years were enrolled, belonging to either gender, presenting to outdoor department, with diagnosed type 2 diabetes mellitus for at least 1 year, on oral hypoglycemic drugs or insulin, and no underlying hypertensive cardiac pathology or diastolic dysfunction. These patients were further analyzed using statistical software based on their 2D echocardiogram findings.

Results: Out of 51 type 2 diabetes mellitus patients, there were more males 32(62.7%) as compared to females 19(37.3%), with mean age of 52.25±8.09 years. We observed that 21(41.2%) patients did not have left ventricular diastolic dysfunction at the time of our study, but among these patients, 13(61.9%) had type 2 diabetes mellitus for 1-3 years while remaining 30(58.8%) patients had both type 2 diabetes mellitus and left ventricular diastolic dysfunction, with 13(25.5%) having grade-I, 10(19.6%) having grade-II and 7(13.7%) having grade-III categorization.

Conclusion: There was an increased risk of left ventricular diastolic dysfunction in type 2 diabetes mellitus with longer duration of disease and higher HbA1c. Patients with type 2 diabetes mellitus to be followed up for diabetic control and monitored for the presence of asymptomatic left ventricular diastolic dysfunction with measures to be taken to prevent it.

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References

Ogilvie LM, Edgett BA, Huber JS, Platt MJ, Eberl HJ, Lutchmedial S, et al. Hemodynamic assessment of diastolic function for experimental models. Am J Physiol Heart Circ Physiol 2020; 318(5): 1139-1158.

https://doi.org/10.1152/ajpheart.00791.2019

Rodica P, James L, Dennis B, Sonia B, Jennifer B, William H, et al. Heart failure: an underappreciated complication of diabetes. A consensus report of the American Diabetes Association. Diabetes Care 2022; 45(7): 1670-1690.

https://doi.org/10.2337/dci22-0015

Masaru O, Reddy YNV, Borlaug BA. Diastolic dysfunction and heart failure with preserved ejection fraction: understanding mechanisms by using noninvasive methods. JACC Cardiovasc Imaging 2020; 13(1): 245-257.

https://doi.org/10.1016/j.jcmg.2019.04.003

Nagueh SF. Left ventricular diastolic function: understanding pathophysiology, diagnosis, and prognosis with echocardio-graphy. JACC Cardiovasc Imaging 2020; 13(1): 228-244.

https://doi.org/10.1016/j.jcmg.2018.10.038

Marc A, Amil M, Barry A. Heart failure with preserved ejection fraction in perspective. Circ Res 2019; 124: 1598-1617.

https://doi.org/10.1161/CIRCRESAHA.118.313278

Azeem S, Khan U, Liaquat A. The increasing rate of diabetes in Pakistan: a silent killer. Ann Med Surg 2022; 79: 108-110.

https://doi.org/10.1016/j.amsu.2022.103951

Meo SA, Zia I, Bukhari IA, Arain SA. Type 2 diabetes mellitus in Pakistan: current prevalence and future forecast. J Pak Med Assoc 2016; 66(12): 1637-1642.

Glovaci D, Fan W, Wong ND. Epidemiology of diabetes mellitus and cardiovascular disease. Curr Cardiol Rep 2019; 21(4): 21.

https://doi.org/10.1007/s11886-019-1107-y

Antakly-Hanon Y, Ben Hamou A, Garçon P, et al. Asymptomatic left ventricular dysfunction in patients with type 2 diabetes free of cardiovascular disease and its relationship with clinical characteristics: the DIACAR cohort study. Diabetes Obes Metab 2021; 23(2): 434-443. https://doi.org/10.1111/dom.14227

Kossaify A, Nasr M. Diastolic dysfunction and the new recommendations for echocardiographic assessment of left ventricular diastolic function: summary of guidelines and novelties in diagnosis and grading. J Diagn Med Sonogr 2019; 35(4): 317-325. https://doi.org/10.1177/8756479319851818

Kabeer A, Hafiz S. Prevalence of Left Ventricular Diastolic Dysfunction by echocardiography in type II diabetes mellitus patients. Int J Adv Med 2019; 6(4): 1334-1336.

https://doi.org/10.18203/2349-3933.ijam20193335

Obokata M, Reddy YNV, Borlaug BA. Diastolic dysfunction and heart failure with preserved ejection fraction: understanding mechanisms by using noninvasive methods. JACC Cardiovasc Imaging 2020; 13(1): 245-257.

https://doi.org/10.1016/j.jcmg.2019.04.003

Kosmala W, Marwick T, et al. Asymptomatic left ventricular diastolic dysfunction. J Am Coll Cardiol Img 2020; 13(1): 215-227. https://doi.org/10.1016/j.jcmg.2019.03.016

Bouthoorn S, Valstar G, Gohar A, et al. The prevalence of Left Ventricular Diastolic Dysfunction and heart failure with preserved ejection fraction in men and women with type 2 diabetes: a systematic review and meta-analysis. Diab Vasc Dis Res 2018; 15(6): 477-493.

https://doi.org/10.1177/1479164118787419

Yadava S, Dolma N, Lamichhane G, et al. Prevalence of diastolic dysfunction in type 2 diabetes mellitus. Kathmandu Univ Med J (KUMJ) 2017; 15(59): 212-216.

Hassan AKM, Abdallah MA, Abdel-Mageed EA, et al. Correlation between Left Ventricular Diastolic Dysfunction and dyslipidaemia in asymptomatic patients with new-onset type 2 diabetes mellitus. Egypt J Intern Med 2021; 33: 8-12.

https://doi.org/10.1186/s43162-020-00021-3

Guria RT, Prasad MK, Mishra B, et al. Association of glycosylated haemoglobin (HbA1c) level with Left Ventricular Diastolic Dysfunction in patients with type 2 diabetes. Cureus 2022; 14(11): e31573. https://doi.org/10.7759/cureus.31573

Chee KH, Tan KL, Luqman I, et al. Prevalence and predictors of Left Ventricular Diastolic Dysfunction in Malaysian patients with type 2 diabetes mellitus without prior known cardiovascular disease. Front Cardiovasc Med 2021; 8: 697540.

https://doi.org/10.3389/fcvm.2021.697540

Foudad H, Latreche S, Quessar A, et al. Relationship between Left Ventricular Diastolic Dysfunction and coronary disease in type 2 diabetes mellitus. Ann Cardiol Angeiol (Paris) 2021; 70(2): 81-85. https://doi.org/10.1016/j.ancard.2021.02.004