Abstract 11866: Left Ventricular Diastolic Function Assessed by Echocardiography and Tissue Doppler Imaging is a Strong Predictor of Cardiovascular Events in Patients With Diabetes Mellitus Type 2
Aims: The aim of the study was to evaluate the independent role of left ventricular systolic function in terms of global longitudinal strain, and diastolic function expressed as the ratio between early diastolic transmitral flow- and mitral annular motion velocities (E/é) in predicting cardiovascular events in patients with diabetes mellitus type 2.
Methods: We prospectively investigated 406 consecutive patients, aged 55-65 years, with diabetes mellitus, who participated in the CARDIPP study. Echocardiography, carotid intima media thickness, carotid-femoral pulse wave velocity, pulse pressure measurement (pp) and glycosylated hemoglobin (HbA1c) were analysed.
Results: Twelve cases of myocardial infarction and seven cases of stroke were identified during the follow-up period of 67 ± 17 months. Univariate Cox regression analysis showed that E/é was a strong predictor of cardiovascular events (HR 1.12; 95 % CI 1.06 to 1.18, p < 0.001) and in a multivariate analysis E/é was prospectively associated with cardiovascular events independent of age, sex, global longitudinal strain, pulse wave velocity, carotid intima media thickness, pp and HbA1c. The addition of HbA1c and pp to E/é increased the predictive value of the model significantly, [(E/é vs. E/é + HbA1c vs. E/é + HbA1c + pp) χ2 = 18.1 vs. χ2 = 23.0 vs. χ2 =30.0, p = 0.030 vs. p = 0.007], but global longitudinal strain did not. An elevated E/é ratio, defined as > 15, was also predictive of major cardiovascular events in a Kaplan-Meyer analysis. The cumulative probability of the development of an event during the follow-up period for patients with an E/é ratio > 15 was 8.6 % compared with 2.6 % for patients E/é ratio ≤ 15, p = 0.021.
Conclusion: Left ventricular diastolic dysfunction expressed as E/é is a strong predictor of myocardial infarction and stroke in middle-aged patients with diabetes mellitus, superior to global longitudinal strain, arterial stiffness and carotid intima media thickness.
Author Disclosures: P. Blomstrand: None. M. Engvall: None. K. Festin: None. T. Lindstrom: None. T. Lanne: None. E. Maret: None. F. Nystrom: None. J. Ouda: None. C. Ostgren: None. J.E. Engvall: None.
- © 2014 by American Heart Association, Inc.