Revelation of subclinical left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus using 2016 ASE/EACVI guidelines

Background: Few studies have used the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) guidelines to detect left ventricular diastolic dysfunction (LVDD) among asymptomatic normotensive type 2 diabetes mellitus (T2DM) patients. Methods: 200 asymptomatic non-hypertensive diabetic cases and 281 controls matched for age and body mass index without evidence of arrhythmias, valvular, myocardial, pericardial or corollary artery disease underwent diastology assessment using 2 dimensional and Mmode echocardiography along with tissue Doppler imaging. Results: The presence of LVDD was seen to be significantly higher among the members of the diabetic group compared to the controls (35 vs. 14; P=0.001). The diabetics with LVDD had a longer duration of diabetes {8.04 +/- 7.75 vs. 5.27 +/- 5.49 years; P=0.04}, along with higher glycated hemoglobin (HbA1c) {8.40 +/- 1.38 vs. 7.80 +/- 1.60%; P=0.05}, fasting blood glucose (FBS) {211.35 +/- 78.15 vs. 187.89 +/- 107.90 mg/dL; P=0.009, 2 hour post prandial blood glucose} (PPBS) {237.89 +/- 107.9 vs. 211.35 +/- 78.15 mg/dL; P=0.04}, serum triglyceride (TG) {246.91 +/- 171.82 vs. 163.44 +/- 99.37 mg/dL; P=0.008} yet had lower serum very low density lipoprotein levels (VLDL) {19.74 +/- 15.01 vs. 27.61 +/- 17.89 mg/dL; P=0.01}. Conclusion: This is one of the few studies so far to have demonstrated a higher occurrence of LVDD specifically among asymptomatic normotensive T2DM patients using the 2016 ASE/EACVI guidelines.