Subclinical LV dysfunction and 10-year outcomes in type 2 diabetes mellitus

Holland, David J., Marwick, Thomas H., Haluska, Brian A., Leano, Rodel, Hordern, Matthew D., Hare, James L., Fang, Zhi You, Prins, Johannes B. and Stanton, Tony (2015) Subclinical LV dysfunction and 10-year outcomes in type 2 diabetes mellitus. Heart, 101 13: 1061-1066. doi:10.1136/heartjnl-2014-307391

Author Holland, David J.
Marwick, Thomas H.
Haluska, Brian A.
Leano, Rodel
Hordern, Matthew D.
Hare, James L.
Fang, Zhi You
Prins, Johannes B.
Stanton, Tony
Title Subclinical LV dysfunction and 10-year outcomes in type 2 diabetes mellitus
Journal name Heart   Check publisher's open access policy
ISSN 1468-201X
Publication date 2015-05-02
Sub-type Article (original research)
DOI 10.1136/heartjnl-2014-307391
Open Access Status Not Open Access
Volume 101
Issue 13
Start page 1061
End page 1066
Total pages 6
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Formatted abstract
Objective: New imaging techniques have permitted the detection of subclinical LV dysfunction (LVD) in up to half of patients with type 2 diabetes mellitus (DM) with a normal EF. However, the connection between early LVD and prognosis is unclear. This study aimed to define the long-term outcome of LVD associated with type 2 DM.

Methods: In this prospective cohort study, 230 asymptomatic patients with type 2 DM underwent measurement of global longitudinal 2D strain (GLS) for detection of LVD and were followed for up to 10 years. All subjects had normal EF (≥50%) and no evidence of coronary artery disease at recruitment. Outcome data were obtained through centralised state-wide death and hospital admission registries. The primary endpoint was all-cause mortality and hospitalisation.

Results: On study entry, almost half (45%) of the cohort had evidence of LVD as detected by GLS. Over a median follow-up of 7.4±2.6 years (range 0.6–9.7 years), 68 patients (30%) met the primary endpoint (LVD: 37%; normal LV function: 24%). GLS was independently associated with the primary endpoint (HR=1.10; p=0.04), as was systolic blood pressure (HR=1.02; p<0.001) and levels of glycosylated haemoglobin (HR=1.28; p=0.011). Patients with LVD had significantly worse outcome than those without (χ2=4.73; p=0.030).

Conclusions: Subclinical LVD is common in asymptomatic patients with type 2 DM, is readily detectable by GLS imaging and is independently associated with adverse outcome.
Keyword Left ventricular dysfunction
Heart failure
Asymptomatic patients
Ejection fraction
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Human Movement and Nutrition Sciences Publications
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 18 times in Thomson Reuters Web of Science Article | Citations
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