Subclinical Left Ventricular Dysfunction over Seven-Year Follow-Up in Type 2 Diabetes Patients without Cardiovascular Diseases

Abstract

Subclinical left ventricular dysfunction (LVD) is common in asymptomatic patients with type 2 diabetes (T2D). This study aimed to define long-term structural and functional disorders of the left ventricle (LV) myocardium over a 7-year follow-up in patients with T2D without cardiovascular diseases (CVD). Of the 120 patients with and without T2D of both sexes aged from 45 to 75 years (57.11 ± 7.9 years), included in the study in 2012–2013, 57 responded to the follow-up study. They were divided into two groups: one with T2D (n = 29), the other without it, the control (n = 28). All patients underwent transthoracic two-dimensional echocardiography with an assessment of standard indicators of systolic and diastolic cardiac function, global longitudinal strain (GLS), laboratory diagnostics of carbohydrate metabolism disorders markers, NT-proBNP, and CRP. The median follow-up duration was 7.2 [7.0–7.8] years. During the follow-up, a statistically significant increase in the incidence of diastolic dysfunction (DD) from 53% to 61% (p = 0.004) was found in the T2D group; no significant dynamics were noted in the control group (p = 0.48). The proportion of patients with reduced GLS (p = 0.036). A significant difference in the frequency of decreased GLS depending on presence of T2D was demonstrated. In conclusion, T2D is an independent risk factor for the worsening of subclinical left ventricular dysfunction in asymptomatic patients with T2D without CVD over 7-year follow-up.

Keywords

• type 2 diabetes
• subclinical left ventricular dysfunction
• diastolic disfunction
• global longitudinal strain