The impact of diabetes duration on left ventricular diastolic function and cardiovascular disease
- Yujeong Kim1,
- Mi-Seung Shin1,
- Yeun Sun Kim1,
- Woong Chol Kang1,
- Bong Roung Kim2,
- Jeonggeun Moon1,
- Wook-Jin Chung1,
- Tae Hoon Ahn1,
- Eak Kyun Shin1
- 1Division of Cardiology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
- 2Department of Internal Medicine, Seoul Medical Center, Seoul, Republic of Korea
- Correspondence to Dr Mi-Seung Shin, Division of Cardiology, Department of Internal Medicine, Gachon University Gil Hospital, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, Korea;
Contributors All listed authors contributed to data collection, analysis, preparing the manuscript and review. YK and M-SS conceived the research idea and designed the study. YSK, JM, WCK, W-JC, THA and EKS carried out the data collection. YK, M-SS and BRK analysed the data. YK, M-SS and WCK prepared the manuscript. All authors read and approved the final manuscript. M-SS is the guarantor of the paper.
- Received 8 September 2011
- Accepted 9 January 2012
- Published Online First 23 February 2012
Objectives The question of whether diabetes mellitus (DM) duration correlates with the severity of dysfunction has not been well studied. We hypothesised that the longer the duration of DM the worse the severity of left ventricular (LV) diastolic dysfunction and increased risk of cardiovascular disease (CVD).
Methods We reviewed 547 diabetic patients between January 2005 and April 2010. Finally, 92 consecutive patients who presented with type 2 DM and who underwent echocardiographic assessment were enrolled according to the selection criteria. In all patients, ischaemic heart disease and heart failure were excluded.
Results Diastolic parameters were significantly worsened with increasing duration of DM (p<0.05). In the ≥7 years DM duration group (n=50), the E/Ea ratio increased significantly and the Ea/Aa ratio decreased significantly, compared with those in the <7 years DM duration group (n=42). CVD developed in 28 patients (30.4%) during the follow-up period. However, the duration of DM showed less statistical correlation with the incidence of CVD (p=0.188) and other LV diastolic function indices did not differ significantly between groups with or without CVD.
Conclusions Alteration of diastolic function induced by DM worsens with increasing duration of DM. DM duration on echocardiographic evaluation time did not differ significantly between the CVD incident and the non-CVD incident groups. The rate of CVD development was not significantly different if the duration of DM was more than 7 years. Therefore, active medical care including echocardiography should be undertaken to prevent CVD from the point of diagnosis of type 2 DM.
Funding This study was supported by an intramural grant from Gachon University Gil Hospital.
Competing interests None.
Ethics approval This study was approved by the institutional review board of Gachon University Gil Hospital.
Provenance and peer review Not commissioned; externally peer reviewed.