NEW ORLEANS — Preclinical diastolic dysfunction was highly prevalent among patients with diabetes, occurring in 24% of more than 1,700 largely unselected patients in a retrospective study.
Diastolic dysfunction without any initial clinical manifestations in patients with either type 1 or type 2 diabetes also had substantial clinical consequences, leading to a significantly increased rate of both heart failure and all-cause mortality during up to 5 years of follow-up, Dr. Aaron M. From reported at the annual scientific sessions of the American Heart Association.
Dr. From, of the Mayo Clinic in Rochester, Minn., and his associates studied the natural history of preclinical diastolic dysfunction in diabetes patients by reviewing the records of 2,770 patients with either type 1 or type 2 diabetes who were residents of Olmsted County, Minn. and who underwent an echocardiographic examination at the clinic during 1996-2006. A total of 1,794 patients were included in the final analysis.
The average age of these patients was 60, about half were women, their average body mass index was 33 kg/m
Using the ratio between the patient's early mitral filling velocity—the E wave—and the mitral annulus velocity—the e' wave—431 (24%) of the 1,784 patients with diabetes had diastolic dysfunction at the time of their echo exam.
Subsequent development of heart failure was identified by finding ICD-9 code 428 in the patient's record. A prior study of Olmsted County patients showed that this code identified 90% of heart failure cases. During up to 5 years of follow-up, the rate of new-onset heart failure was 37% in patients with diastolic dysfunction at baseline and 17% in those without diastolic dysfunction, a statistically significant difference, said Dr. From, who also reported that he and his coauthors had no conflicts of interest related to the study.