| Prevalence and prognosis of left ventricular systolic dysfunction in asymptomatic diabetic patients without known coronary artery disease referred for stress single-photon emission computed tomography and assessment of left ventricular function. | |
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MedLine Citation:
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PMID: 17719308 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The prevalence and prognosis of reduced left ventricular ejection fraction (LVEF) in asymptomatic diabetic patients without known coronary artery disease (CAD) are not known. METHODS: We examined 1046 asymptomatic diabetic patients (age 60 +/- 13 years, 69% male) without known CAD referred to a tertiary referral center for stress single-photon emission computed tomography (SPECT) and assessment of LVEF. Patients were stratified according to the presence of normal LVEF (> or = 50%), mildly reduced LVEF (35%-49%), or moderately/severely reduced LVEF (< 35%). Single-photon emission computed tomographic images were classified as low, intermediate, or high risk based on the summed stress score (normal = 56). The mean follow-up was 5.3 +/- 3.3 years. RESULTS: The prevalence of reduced LVEF was 16.7% (n = 175, mean LVEF 40.0% +/- 7.7%). This group was older (63 +/- 11 vs 59 +/- 14 years, P = .005), had more peripheral arterial disease (45% vs 29%, P < .001), and had a higher prevalence of electrocardiographic Q waves (21% vs 9%, P < .001) than the group without reduced LVEF. Mean summed stress (44.8 +/- 9.8 vs 51.7 +/- 6.3, P < .001), summed reversibility (4.7 +/- 5.0 vs 2.9 +/- 4.5, P < .001), and summed rest scores (49.4 +/- 7.2 vs 54.6 +/- 3.1, P < .001) were significantly more abnormal in the reduced LVEF group. High-risk summed stress score was significantly more common in the reduced LVEF group (46% vs 16%, P < .001). Survival was significantly lower in patients with any reduction in LVEF compared with those without reduced LVEF (10-year survival, 29% vs 57%, P < .0001). By multivariate analysis, reduced LVEF was independently associated with increased mortality (adjusted chi2 = 6.26, P = .01). CONCLUSIONS: In this population of asymptomatic diabetic patients without known CAD referred for stress SPECT, 1 in 6 patients had reduced LVEF. Most of these patients have intermediate-/high-risk SPECT scans. The annual mortality rates of the groups with and without reduced LVEF were 7% and 4%, respectively. |
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Authors:
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Panithaya Chareonthaitawee; Paul Sorajja; Navin Rajagopalan; Todd D Miller; David O Hodge; Robert L Frye; Raymond J Gibbons |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American heart journal Volume: 154 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-27 Completed Date: 2007-09-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 567-74 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA. chareonthaitawee.panithaya@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Diabetes Complications
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epidemiology*,
physiopathology Exercise Test Female Humans Male Middle Aged Positron-Emission Tomography* / methods Prevalence Prognosis Systole Ventricular Dysfunction, Left / diagnosis*, epidemiology*, physiopathology Ventricular Function, Left |
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