Clinical and echocardiographic determinants of heart disease in uncomplicated type II Nigerian diabetic patients

Abstract

Background: Recent epidemiological studies indicate an increasing prevalence of type 2 diabetes mellitus (T2DM) in the world. T2DM is now widely accepted as a major predisposing factor to ischemic heart disease, stroke, dilated cardiomyopathy, and congestive heart failure (HF). Significant subclinical myocardial dysfunction before overt HF can easily be detected by Echocardiography. Aims: The aim is to detect the prevalence and types of abnormal left ventricular (LV) functions and geometry in uncomplicated, normoalbuminuric normotensive T2DM in Nigeria, before the onset of overt heart disease. Subjects and Methods: This was a cross-sectional study conducted at the diabetic and Cardiology clinics of University Teaching Hospital State, Nigeria, from January 2013 to March 2014. Diabetic patients positive for albuminuria were excluded and echo-derived indices of LV functions and geometry were compared between the two groups. Results: Fifty normotensive T2DM patients who had no albuminuria were selected with 59 age- and sex-matched normal controls for the study. LV diastolic dysfunction (LVDD) was significantly more in normoalbuminuric T2DM compared to healthy controls (54% vs. 36%) P = 0.007. LV systolic dysfunction was rare in T2DM and in controls. Abnormal geometric patterns were higher in patients than controls, 70% versus 36% (P = 0.002). Age (odds ratio [OR] =1.05, 95% confidence interval (CI) of 1.01–1.11, P = 0.0273) and presence of diabetes mellitus (DM) (OR = 2.70, 95% CI of 1.12–6.53, P = 0.0273) were the independent predictor of LVDD in the participants. Conclusions: LV diastolic function and geometry are altered in Nigerian normotensive normoalbuminuric T2DM; therefore, its prognostic importance and effectiveness of intervention need to be further elucidated.