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Risk Factors Associated with Left Ventricular Diastolic Dysfunction in Type 2 Diabetic Patients without Hypertension
Jung Hyun Noh, Joon Hyung Doh, Sung Yun Lee, Tae Nyun Kim, Hyuk Lee, Hwa Young Song, Jeong Hyun Park, Kyung Soo Ko, Byoung Doo Rhee, Dong Jun Kim
Korean Diabetes J. 2010;34(1):40-46.   Published online February 28, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.1.40
  • 5,661 View
  • 52 Download
  • 8 Crossref
AbstractAbstract PDFPubReader   
Background

Hypertension and age are recognized as important risk factors for left ventricular (LV) diastolic dysfunction. Some studies have shown that diabetes itself may also be an independent risk factor for LV diastolic dysfunction, although this is controversial. The aim of this study was to determine the factors associated with LV diastolic dysfunction in patients with type 2 diabetes in the absence of hypertension or ischemic heart disease (IHD).

Methods

Participants in this study consisted of 65 type 2 diabetes patients (M : F = 45 : 20; mean age 51 [26 to 76] years; mean body mass index [BMI] 25.0 ± 2.5 kg/m2) without hypertension, heart disease, or renal disease. Individuals with ischemic electrocardiographic changes were excluded. LV diastolic function was evaluated by Doppler echocardiographic studies.

Results

Fifteen patients (23.1%) showed LV diastolic dysfunction on Doppler echocardiographic studies. Patients with LV diastolic dysfunction were older than those without diastolic dysfunction (60.0 ± 2.5 vs. 50.5 ± 1.9 years; P < 0.01). After adjusting for age and sex, BMI was higher (26.6 ± 0.7 vs. 24.6 ± 0.3 kg/m2; P < 0.01) and diabetes duration was longer (9.65 ± 1.48 vs. 4.71 ± 0.78 years; P < 0.01) in patients with LV diastolic dysfunction than in those without diastolic dysfunction. There were no differences in sex, smoking, blood pressure, lipid profiles, hemoglobin A1C, fasting glucose, fasting insulin, or diabetic microvascular complications between the LV diastolic dysfunction group and the normal diastolic function group. After adjusting for age, sex, and BMI, diabetes duration was found to be independently associated with LV diastolic dysfunction (odds ratio 1.38; confidence interval 1.12 to 1.72; P = 0.003).

Conclusion

These results suggest that diabetes duration may be a risk factor for LV diastolic dysfunction in type 2 diabetic patients without hypertension or IHD.

Citations

Citations to this article as recorded by  
  • Reducing Cardiac Steatosis: Interventions to Improve Diastolic Function: A Narrative Review
    Kiyan Heshmat-Ghahdarijani, Roya Modaresi, Sobhan Pourmasjedi, Setayesh Sotoudehnia Korani, Ali Rezazadeh Roudkoli, Razieh Ziaei, Armita Farid, Mehrnaz Salehi, Afshin Heidari, Sina Neshat
    Current Problems in Cardiology.2023; 48(8): 101739.     CrossRef
  • Glycemic variability is associated with diastolic dysfunction in patients with type 2 diabetes
    Yana Dzhun, Georgy Mankovsky, Nadiya Rudenko, Yevgen Marushko, Yanina Saienko, Borys Mankovsky
    Journal of Diabetes and its Complications.2023; 37(11): 108519.     CrossRef
  • Lipids and diastolic dysfunction: Recent evidence and findings
    Padideh Daneii, Sina Neshat, Monir Sadat Mirnasiry, Zahra Moghimi, Fatemeh Dehghan Niri, Armita Farid, Setayesh Sotoudehnia Korani, Masood Shekarchizadeh, Kiyan Heshmat-Ghahdarijani
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(6): 1343.     CrossRef
  • Does diabetes increase the risk of cardiovascular events in patients with negative treadmill stress echocardiography?
    So Young Yang, Hui-Jeong Hwang
    Endocrine Journal.2022; 69(7): 785.     CrossRef
  • Factors associated with left ventricular diastolic dysfunction in patients with septic shock
    Wei-Dong Ge, Feng-Zhi Li, Bang-Chuan Hu, Li-Hong Wang, Ding-Yuan Ren
    European Journal of Medical Research.2022;[Epub]     CrossRef
  • An in-depth analysis of glycosylated haemoglobin level, body mass index and left ventricular diastolic dysfunction in patients with type 2 diabetes
    Xin Zuo, Xueting Liu, Runtian Chen, Huiting Ou, Jiabao Lai, Youming Zhang, Dewen Yan
    BMC Endocrine Disorders.2019;[Epub]     CrossRef
  • Early detection of left ventricular diastolic dysfunction using conventional and speckle tracking echocardiography in a large animal model of metabolic dysfunction
    Mark M. P. van den Dorpel, Ilkka Heinonen, Sanne M. Snelder, Hendrik J. Vos, Oana Sorop, Ron T. van Domburg, Daphne Merkus, Dirk J. Duncker, Bas M. van Dalen
    The International Journal of Cardiovascular Imaging.2017;[Epub]     CrossRef
  • Risk Factors Associated with Left Ventricular Diastolic Dysfunction in Type 2 Diabetic Patients without Hypertension (Korean Diabetes J 2010;34:40-6)
    Dong-Lim Kim
    Korean Diabetes Journal.2010; 34(2): 135.     CrossRef
Diastolic Dysfunction of Left Ventricle by Cardiovascular Autonomic Neuropathy in Type 2 Diabetic Patients Without Cardiovascular Symptom.
Duk Kyu Kim, Mi Kyoung Park, Do Young Kang
Korean Diabetes J. 2001;25(3):230-239.   Published online June 1, 2001
  • 1,092 View
  • 22 Download
AbstractAbstract PDF
BACKGROUND
We investigated the effect of cardiovascular autonomic neuropathy for left ventricular function in cardiovascular symptom-free type 2 diabetic patients without other major risk factors known to cause cardiac dysfunction, especially diastolic dysfunction. METHODS: Forty seven patients (M:F=20:27, 53+/-10 years) with type 2 DM were enrolled in this study. None of the subjects had the macrovascular diabetic complications, hypertension, hypertrophic cardiomyopathy, valvular heart disease, alcoholic heart disease, congenital heart disease and older age (> 65 years). The patients were tested for cardiovascular autonomic neuropathy using five non-invasive tests of autonomic function. The response to each test was graded as 0, 0.5, 1. A patient was classified as having definite cardiovascular autonomic neuropathy if total score was 2 or more. Using these criteria, 26 patients (Group A) were determined to have cardiovascular autonomic neuropathy. Others were 21 patients (Group B). Tc-99 m RBC gated blood pool scintigraphy was performed as routine standard protocol. RESULTS: The degree of age, sex, body mass index (BMI), duration of diabetes, level of insulin, C-peptide, fructosamine, fasting plasma glucose, total cholesterol (TC), triglyceride (TG), HDL, LDL, BUN, creatinine and incidence of retinopathy, microalbuminuria were not different between group A and B. Heart rate response to Valsalva maneuver, heart rate response to standing were different between Group A and B (p=0.008, p=0.001, respectively). Ejection fraction of left ventricle were normal (> 50%) in all of patients. Maximal filling rate, average filling rate, maximal ejection rate and average ejection rate were increased in patients with cardiac autonomic neuropathy (p=0.03, p=0.05, p=0.02, p=0.04, respectively). Total score of autonomic function was significantly correlated with maximal filling rate (r=0.38, p=0.01), with average filling rate (r=0.37, p=0.01) and with maximal ejection rate (r=0.37, p=0.01). Maximal filling rate was most correlated with resting pulse (r=0.58, p<0.01). CONCLUSION: Cardiovascular autonomic neuropathy as single factor may result in diastolic dysfunction of left ventricle in cardiovascular symptom-free type 2 diabetic patients without other major factor known to cause cardiac diastolic dysfunction.

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