Subclinical left ventricular dysfunction and glycaemic control over long-term follow-up in individuals with type 2 diabetes mellitus: A prospective follow-up study

Abstract

Background: Subclinical left ventricular dysfunction(LVD) is present in up to half of individuals with type 2 diabetes mellitus(T2DM) and is associated with adverse prognosis. The development of LVD and change in global longitudinal strain(GLS) over long-term follow-up in individuals with T2DM is unknown. Methods: 102 asymptomatic individuals (age 56 ± 8yrs) with T2DM underwent clinical review, blood tests and resting echocardiography at baseline and after a follow-up over 9yrs. Participants were free of ischaemic/valvular heart disease, and had normal ejection fraction(>50%). GLS was used to identify LVD (GLS worse than-18.9%). Results: After 9.4 ± 0.7years(median), GLS decreased from-19.2 ± 2.3% to-17.4 ± 2.8% (p < 0.001) and there were more individuals with LVD (42% to 68%, p< 0.001). Those with poorer glycaemic control at follow-up (i.e. HbA1c>7) had sig-nificant deterioration in GLS compared to those with optimal control (p = 0.039). Independent predictors of deteriorating GLS were age, weight, HbA1c and use of statins (p<0.05 for all). Oral antidiabetic medications (including metformin) were protective (p < 0.001). Conclusion: Subclinical LVD is common in asymptomatic individuals with T2DM and progresses over long-term follow-up. Progression of LVD is associated with poor gly-caemic control, advancing age, increases in body weight and statin use, whereas diabetes therapy was protective. Therapeutic interventions in glycaemic control may prevent progression of LVD over long-term follow-up. [Figure Presented].L6212327582018-03-20 <br />