Assessment of subclinical left ventricular systolic and diastolic dysfunction in patients with Type 2 diabetes mellitus on follow up at Tikur Anbessa Specialized Hospital: A Case - Control Study

Abstract

Abstract Background People with diabetes are at increased risk of cardiovascular diseases. And cardiovascular diseases are the most common cause of morbidity and mortality in diabetic patients. A peculiar feature of cardiovascular diseases in diabetic patients is that they can have a significant level of heart disease while being asymptomatic. There is a paucity of data regarding the subclinical imaging features of diabetes in Africa, particularly in Ethiopia. Objective Our main objective was to compare the magnitude and spectrum of left ventricular systolic and diastolic dysfunction among asymptomatic Type 2 diabetic patients versus a normotensive, non-diabetic control group. We also assessed the determinants of left ventricular diastolic and systolic dysfunction in these patients. Methods This is a case-control study that was conducted at the Tikur Anbessa specialized hospital in Addis Ababa, Ethiopia. Standard transthoracic echocardiography was done for all selected patients with Type 2 diabetes mellitus on follow-up and for normotensive and non-diabetic controls that came to the hospital for other complaints. Ethical approval was obtained from the IRB of the department. Structured questionnaires were used to collect baseline characteristics, comorbidities, HgbA1c, LDL, triglyceride levels, and the duration and complications of diabetes. Statistical analysis was done using SPSS 25.0. Results The mean age of participants was 56 in both groups, with a similar proportion of male and female participants (56% and 44%, respectively). Left ventricular systolic and diastolic dysfunction were significantly more prevalent among diabetic patients than their sex and age matched controls. Within the diabetic participants aged > 60, dyslipidemia, metformin and glibenclamide use, a high serum triglyceride level, neuropathy, and statin use were found to be associated with the occurrence of left ventricular diastolic dysfunction. Chronic kidney disease and neuropathy were associated with left ventricular systolic dysfunction. Conclusion Left ventricular systolic and diastolic dysfunction were significantly more prevalent among diabetic patients than their sex and age matched controls.