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Impact of left ventricular longitudinal diastolic functional reserve on clinical outcome in patients with type 2 diabetes mellitus

Authors
 Sung-Ai Kim  ;  Chi-Young Shim  ;  Jin-Mi Kim  ;  Hyun-Jin Lee  ;  Dong-Hoon Choi  ;  Eui-Young Choi  ;  Yangsoo Jang  ;  Namsik Chung  ;  Jong-Won Ha 
Citation
 HEART, Vol.97(15) : 1233-1238, 2011 
Journal Title
HEART
ISSN
 1355-6037 
Issue Date
2011
MeSH
Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/physiopathology* ; Diastole ; Echocardiography, Stress/methods ; Female ; Follow-Up Studies ; Heart Ventricles/diagnostic imaging* ; Heart Ventricles/physiopathology ; Humans ; Male ; Middle Aged ; Myocardial Contraction/physiology* ; Prognosis ; Retrospective Studies ; Stroke Volume/physiology ; Ventricular Dysfunction, Left/diagnosis ; Ventricular Dysfunction, Left/etiology ; Ventricular Dysfunction, Left/physiopathology* ; Ventricular Function, Left/physiology*
Abstract
BACKGROUND: Left ventricular longitudinal diastolic functional reserve (DFR), as assessed by the change in early diastolic mitral annular velocity (E') during exercise, is abnormal in patients with type 2 diabetes mellitus (DM). However, the impact of left ventricular longitudinal DFR on clinical outcome has not been explored. This study evaluated the incremental prognostic value of left ventricular DFR in patients with type 2 DM without overt heart disease.

METHODS: Of 1485 patients who were referred for exercise stress echocardiography, 197 consecutive patients (mean age, 58 years; 84 men) with type 2 DM without overt heart disease were identified. Left ventricular longitudinal DFR was defined as the change in E' from resting to exercise (ΔE'). The endpoint was a composite of death and hospitalisation for heart failure (HF).

RESULTS: During a median follow-up of 57 months (range 6-90), 18 of 197 patients (9.1%) had adverse events (12 deaths, six hospitalisations for HF). Independent predictors of adverse events in a Cox regression analysis were estimated glomerular filtration rate (HR 0.97; 95% CI 0.95 to 0.98; p<0.001), DM duration (HR 1.07; 95% CI 1.01 to 1.14; p=0.018) and ΔE' (HR 0.58; 95% CI 0.40 to 0.85; p=0.005). In an incremental model, the addition of stress echo data significantly increased the χ² of the clinical and resting left ventricular function model, from 40.5 to 46.6 (p=0.005).

CONCLUSION: Assessment of left ventricular longitudinal DFR during exercise provided incremental prognostic information in patients with type 2 DM without overt heart disease.
Full Text
http://heart.bmj.com/content/97/15/1233.long
DOI
10.1136/hrt.2010.219220
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Ai(김성애)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93377
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