Document Detail


Pre-clinical diabetic cardiomyopathy: prevalence, screening, and outcome.
MedLine Citation:
PMID:  20581103     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Diabetic cardiomyopathy, characterized by left ventricular (LV) dysfunction and LV hypertrophy independent of myocardial ischaemia and hypertension, could contribute to the increased life-time risk of congestive heart failure seen in patients with diabetes. We assessed prospectively the prevalence, effectiveness of screening methods [brain natriuretic peptide (BNP) and C-reactive protein in combination with clinical parameters], and outcome of pre-clinical diabetic cardiomyopathy.
METHODS AND RESULTS: We studied 100 adults (mean age 57.4 +/- 10.2 years, 44% females) with diabetes and no previous evidence of structural heart disease. By echocardiography, diabetic cardiomyopathy was present in 48% of patients. Screening with combinations of clinical parameters (gender, systolic blood pressure, and body mass index), but not BNP, resulted in high negative predictive values for diabetic cardiomyopathy. During a mean follow-up of 48.5 +/- 9.0 months, in the groups with and without diabetic cardiomyopathy, 12.5 vs. 3.9% (P < 0.2) patients died or experienced cardiovascular events and 37.5 vs. 9.6% (P < 0.002) had a deterioration in NYHA functional class. Overall event-free survival was 54 vs. 87% (P = 0.001) in the groups with and without diabetic cardiomyopathy, respectively. Brain natriuretic peptide was an independent predictor of events [odds ratio 3.5 (1.1-10.9), P = 0.02].
CONCLUSION: Pre-clinical diabetic cardiomyopathy is common. Screening with combinations of simple clinical parameters, but not BNP, can be useful to identify those patients needing further evaluation. Patients with pre-clinical diabetic cardiomyopathy are at increased risk for functional deterioration and possibly cardiovascular events during follow-up. Brain natriuretic peptide was shown to be an independent predictor of future events.
Authors:
Stephanie Kiencke; Rolf Handschin; Ruth von Dahlen; Jürgen Muser; Hans Peter Brunner-Larocca; Jörg Schumann; Barbara Felix; Kaspar Berneis; Peter Rickenbacher
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-06-25
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2011-01-11     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  951-7     Citation Subset:  IM    
Affiliation:
Cardiology Division, Kantonsspital Bruderholz, CH-4101 Bruderholz, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Diabetic Cardiomyopathies / complications,  diagnosis,  epidemiology*
Echocardiography, Doppler
Electrocardiography
Female
Follow-Up Studies
Humans
Hypertrophy, Left Ventricular / complications,  diagnosis,  epidemiology
Immunoassay
Male
Mass Screening*
Middle Aged
Natriuretic Peptide, Brain / blood
Prevalence
Prognosis
Prospective Studies
Risk Factors
Time Factors
Ventricular Dysfunction, Left / complications,  diagnosis,  epidemiology
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
Eur J Heart Fail. 2010 Sep;12(9):898-900   [PMID:  20729373 ]

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