Study of Systolic and Diastolic Dysfunction among Normotensive Patients with Type 2 Diabetes Mellitus ??? A Cross???Sectional Study from Puducherry, India

Author(s): I.S.S. Suman Babu1, Sethu Prabhu Shankar2, K. Harshavardhan Reddy3, Surya Usha Surendran Nair4

Diabetes mellitus (DM) single-handedly accounts for 75 – 90 % of excess coronary
artery disease (CAD) risk seen in persons suffering from it and it also enhances
and amplifies the effects of other traditional cardiovascular risk factors. After
adjusting for concomitant risk factors such as hypertension and hyperlipidemia,
there still remains an excess risk for cardiovascular disease (CVD) in people with
diabetics. In this study, we wanted to evaluate left ventricular (LV) systolic and
diastolic dysfunction in normotensive diabetic patients.
A cross sectional comparative study was performed from January 2016 to
September 2017 on 50 diabetics and 50 age and sex matched healthy controls.
Adult patients of both sexes with diabetes mellitus who are normotensive were
included as cases. Patients with known heart disease, chronic kidney disease,
thyroid disorders were excluded from the study. 2D transthoracic echocardiogram
(ECHO) with M mode was used for assessing systolic and diastolic function.
Mean ejection fraction was lower in patients group (59.76) as compared to control
group (64.74) with 8 % of cases with a value of< 50 %. Fractional shortening was
also lower in patients (29.14) compared to controls (34.86) with 12 % patients
having a value of < 25 %. E/A ratio was 1.12 in patients when compared to 1.36
in controls with 32 % of patients having value < 1. Mean isovolumic relaxation
time was 96.52 in patients when compared to 87.42 in controls with 24 % patients
having value > 100 msec.
Normotensive diabetics are prone to left ventricular dysfunction. Diastolic
dysfunction is more common than systolic dysfunction.