The development of heart failure in patients with diabetes mellitus and pre-clinical diastolic dysfunction a population-based study.
The development of heart failure in patients with diabetes mellitus and pre-clinical diastolic dysfunction a population-based study.
复制标题
糖尿病患者的心力衰竭和基于人群的研究。
DOI：
10.1016/j.jacc.2009.12.003
复制
发表时间：
2010-01-26
影响因子：
24
通讯作者：
Chen, Horng H.
中科院分区：
文献类型：
--
作者：
From, Aaron M.;Scott, Christopher G.;Chen, Horng H.
Evaluate the outcomes of preclinical diastolic dysfunction in diabetic patients Studies have reported a high prevalence of preclinical diastolic dysfunction among patients with diabetes mellitus. We identified all diabetic patients with a tissue Doppler assessment of diastolic function in Olmsted County, MN from 2001 to 2007. Diastolic dysfunction was defined as a Doppler mitral E/e′ ratio >15. The main outcome was the development of heart failure (HF). Secondary outcomes were the development of atrial fibrillation and death. Overall, 1,760 diabetic patients with a tissue Doppler echocardiographic assessment of diastolic function were identified; 411 patients (23%) had diastolic dysfunction. Using multivariable Cox's proportional hazard modeling, we determined that for every 1 unit increase in the mitral E/e′ ratio, the hazard of HF increased by 3% (HR=1.03, 95% CI=1.01-1.06; p=0.006) and that diastolic dysfunction was associated with the subsequent development of HF after adjustment for age, sex, body mass index, hypertension, coronary disease and echocardiographic parameters (HR=1.61, 95% CI=1.17-2.20; p=0.003). The cumulative probability of the development of HF at 5 years for diabetic patients with diastolic dysfunction was 36.9% compared to 16.8% for patients without diastolic dysfunction (P<0.001). Furthermore, diabetic patients with diastolic dysfunction had a significantly higher mortality compared to those without diastolic dysfunction. We demonstrated that an increase in the E/e′ ratio in diabetic patients is associated with the subsequent development of HF and increased mortality independent of hypertension, coronary disease or other echocardiographic parameters.
Evaluate the outcomes of preclinical diastolic dysfunction in diabetic patients Studies have reported a high prevalence of preclinical diastolic dysfunction among patients with diabetes mellitus. We identified all diabetic patients with a tissue Doppler assessment of diastolic function in Olmsted County, MN from 2001 to 2007. Diastolic dysfunction was defined as a Doppler mitral E/e′ ratio >15. The main outcome was the development of heart failure (HF). Secondary outcomes were the development of atrial fibrillation and death. Overall, 1,760 diabetic patients with a tissue Doppler echocardiographic assessment of diastolic function were identified; 411 patients (23%) had diastolic dysfunction. Using multivariable Cox's proportional hazard modeling, we determined that for every 1 unit increase in the mitral E/e′ ratio, the hazard of HF increased by 3% (HR=1.03, 95% CI=1.01-1.06; p=0.006) and that diastolic dysfunction was associated with the subsequent development of HF after adjustment for age, sex, body mass index, hypertension, coronary disease and echocardiographic parameters (HR=1.61, 95% CI=1.17-2.20; p=0.003). The cumulative probability of the development of HF at 5 years for diabetic patients with diastolic dysfunction was 36.9% compared to 16.8% for patients without diastolic dysfunction (P<0.001). Furthermore, diabetic patients with diastolic dysfunction had a significantly higher mortality compared to those without diastolic dysfunction. We demonstrated that an increase in the E/e′ ratio in diabetic patients is associated with the subsequent development of HF and increased mortality independent of hypertension, coronary disease or other echocardiographic parameters.
登录
查看更多内容
影响因子：
2.8
作者：
From, Aaron M.;Scott, Christopher G.;Chen, Horng H.
通讯作者：
Chen, Horng H.
影响因子：
16.2
作者：
Poirier, P;Bogaty, P;Dumesnil, JG
通讯作者：
Dumesnil, JG
影响因子：
120.7
作者：
Redfield, MM;Jacobsen, SJ;Rodeheffer, RJ
通讯作者：
Rodeheffer, RJ
影响因子：
24
作者：
Galderisi, Maurizio
通讯作者：
Galderisi, Maurizio
影响因子：
4.8
作者：
Lee, M;Gardin, JM;Ward, BJ
通讯作者：
Ward, BJ