EFFECT OF GLYCAEMIC STATUS ON LEFT VENTRICULAR DIASTOLIC FUNCTION IN NORMOTENSIVE TYPE 2 DIABETIC PATIENTS

Hameed ullah, Muhammad Faheem, Sher Bahadar, Muhammad Hafizullah, Shahzad Najeeb

Abstract


Background: Diabetes is associated with Left ventricular diastolic and systolic dysfunction known as
diabetic cardiomyopathy. Echocardiography is helpful for the detection of diastolic dysfunction and
Echocardiographic screening for asymptomatic diabetic cardiomyopathy should be performed in all
asymptomatic diabetic subjects. Identification of diabetic cardiomyopathy should result in the initiation
of therapies to prevent the progression of diabetic cardiomyopathy. The objectives of this Descriptive
case series was to determine the effect of glycaemic status on left ventricular diastolic function in
normotesive type 2 diabetic patients. Methods: This study was performed at Cardiology department,
PGMI Lady Reading Hospital, Peshawar from March 2007 to September 2007. Sixty normotesive type
2 diabetic patients were enrolled, 20 well control, 20 moderately control and 20 poorly control (Group-
3). Main outcome measures was Left ventricular diastolic function determined by Echocardiography.
Results: Out of 60 patients there were 32 (53.3%) males and 28 (46.7%) females. Mean E/A ratio in
Group 1 was 1.380.29, in Group 2 was 1.160.39 and in Group 3 was 0.600.15 (p<0.05). IVRT in
Group-1 was 917.87 mSec, in Group-2 was 1007.83 mSec and in Group-3 was 1096.45 mSec
(p<0.05). DT in Group 1 was 207.2±12.6 mSec, in Group 2 was 21811.3 mSec and in Group 3 was
229.7±9.52 mSec (p<0.05). Mean Em at mitral annulus in Group-1 was 0.14±0.04 m/Sec, in Group-2
was 0.11±0.04 m/Sec and in Group-3 was 0.10±0.03 m/Sec (p=0.002). Left ventricular diastolic
dysfunction was documented in 4 (25%) patients in Group-1, 9 (45%) patients in Group-2 and 16
(80%) patients in Group-3 (p<0.05). There was Strong correlation between HbA1c level and diastolic
indexes (p<0.05). Conclusion: Diastolic dysfunction is more frequent in poorly controlled diabetic
patients and its severity is correlated with glycaemic control.
Keywords: Type 2 diabetes mellitus, left ventricular diastolic function, Deceleration time

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