Diagnosis of Nonischemic Stage B Heart Failure in Type 2 Diabetes Mellitus: Optimal Parameters for Prediction of Heart Failure

JACC. Cardiovascular Imaging
Ying WangThomas H Marwick

Abstract

This study sought to identify whether impaired global longitudinal strain (GLS), diastolic dysfunction (DD), or left atrial enlargement (LAE) should be added to stage B heart failure (SBHF) criteria in asymptomatic patients with type 2 diabetes mellitus. SBHF is a precursor to clinical heart failure (HF), and its recognition justifies initiation of cardioprotective therapy. However, original definitions of SBHF were based on LV hypertrophy and impaired ejection fraction. Patients with asymptomatic type 2 diabetes mellitus ≥65 years of age (age 71 ± 4 years; 55% men) with preserved ejection fraction and no ischemic heart disease were recruited from a community-based population. All underwent a standard clinical evaluation, and a comprehensive echocardiogram, including assessment of left ventricular hypertrophy (LVH), LAE, DD (abnormal E/e'), and GLS (<16%). Over a median follow-up of 1.5 years (range 0.5 to 3), 20 patients were lost to follow-up, and 290 individuals were entered into the final analyses. In this asymptomatic group, LV dysfunction was identified in 30 (10%) by DD, 68 (23%) by LVH, 102 (35%) by LAE, and 68 (23%) by impaired GLS. New-onset HF developed in 45 patients and 4 died, giving an event rate of 112/1,000 per...Continue Reading

Citations

May 14, 2019·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Seong Hwan KimChol Shin
Apr 22, 2020·Echocardiography·Prasanna VenkataramanThomas H Marwick
Dec 17, 2020·European Journal of Clinical Investigation·Ioan-Alexandru MinciunăAngela Cozma
Jan 18, 2020·Journal of the American College of Cardiology·Y Chandrashekhar
Feb 2, 2021·Cardio-Oncology·Raquel Araujo-GutierrezBarry H Trachtenberg
Feb 18, 2021·Current Cardiology Reports·Kawa Haji, Thomas H Marwick
Oct 14, 2020·The Journal of Clinical Endocrinology and Metabolism·Koki NakanishiIssei Komuro
Mar 22, 2021·JACC. Cardiovascular Imaging·Geneviève A Derumeaux, Thomas d'Humières
Apr 26, 2021·Diabetes Research and Clinical Practice·Paul ValensiErwan Donal
Jun 21, 2021·JACC. Cardiovascular Imaging·Elizabeth L PotterThomas H Marwick
Jun 24, 2021·Cardiovascular Diabetology·Lorenzo NestiAndrea Natali
Aug 6, 2021·Therapeutic Advances in Endocrinology and Metabolism·Gaurav S GulsinGerry P McCann
Aug 26, 2021·Integrated Blood Pressure Control·Manoel Paz LandimJose Fernando Vilela-Martin

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