Albuminuria and left ventricular mass index are associated with left ventricular diastolic dysfunction in type 2 diabetes mellitus patients

Background: Diabetes mellitus (DM) is associated with a substantially increased risk of developing heart failure. To verify the risk factors of preclinical left ventricular diastolic dysfunction (LVDD) in type 2 diabetic patients, we assessed the LVDD by tissue Doppler echocardiography and its relationship with various parameters in asymptomatic patients with type 2 DM. Methods: We studied 100 asymptomatic patients with type 2 DM [age 61.6 ± 9.7 years, body mass index (BMI) 25.5 ± 4.8 kg/m2]. All patients underwent clinical evaluation, retinopathy, and laboratory assessment for BMI, fasting plasma glucose, C-peptide, lipids, Hemoglobin A1c (HbA1c), and urine albumin to creatinine ratio. Echocardiography including tissue Doppler imaging were performed to assess LVDD, which was defined with E/A < 0.75; or with 0.75 ≤ E/A and E/e' ≥ 10. Normal diastolic function was defined with 0.75 ≤ E/A < 1.5 and E/e' < 10. Patients with LV ejection fraction (LVEF) <50 % were excluded. Results: Sixty-five patients were classified as having LVDD and 35 as having normal diastolic function. The logistic analysis revealed that age [odds ratio (OR) 1.14, 95 % confidence interval (CI) 1.06-1.22, P = 0.001), women (OR 7.63, 95 % CI 2.18-26.7, P = 0.002), left ventricular mass index (LVMI) (OR 1.04, 95 % CI 1.01-1.08, P = 0.004), and albuminuria (OR 7.95 95 % CI 1.74-21.6, P = 0.005) were associated with LVDD. Conclusion: This study reveals a high incidence of LVDD in asymptomatic type 2 DM patients and, this finding was correlated with age, sex, LVMI and albuminuria. Screening for albuminuria and echocardiography may be useful for identifying individuals with a high cardiovascular risk and possible LVDD in type 2 DM patients. © 2013 The Japan Diabetes Society.