doiSerbia

Asymptomatic cardiovascular manifestations in diabetes mellitus: Left ventricular diastolic dysfunction and silent myocardial ischemia

Seferović-Mitrović Jelena P. (Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd)
Lalić Nebojša M. (Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Vujisić-Tešić Bosiljka (Medicinski fakultet, Beograd + Klinika za kardiologiju, Klinički centar Srbije, Beograd)
Lalić Katarina (Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Jotić Aleksandra (Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Ristić Arsen D. (Medicinski fakultet, Beograd + Klinika za kardiologiju, Klinički centar Srbije, Beograd)
Giga Vojislav (Klinika za kardiologiju, Klinički centar Srbije, Beograd)
Tešić Milorad (Klinika za kardiologiju, Klinički centar Srbije, Beograd)
Milić Nataša (Institut za medicinsku statistiku i informatiku, Medicinski fakultet, Beograd)
Lukić Ljiljana (Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd)
Miličić Tanja (Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd)
Singh Sandra (Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd)
Seferović Petar M. (Medicinski fakultet, Univerzitet u Beogradu, Beograd + Klinika za kardiologiju, Klinički centar Srbije, Beograd)

Introduction. Several cardiovascular manifestations in patients with diabetes may be asymptomatic. Left ventricular diastolic dysfunction (LVDD) is considered to be the earliest metabolic myocardial lesion in these patients, and can be diagnosed with tissue Doppler echocardiography. Silent myocardial ischemia (SMI) is a characteristic and frequently described form of ischemic heart disease in patients with diabetes. Objective. The aim of the study was to assess the prevalence of LVDD and SMI in patients with type 2 diabetes, as well as to compare demographic, clinical, and metabolic data among defined groups (patients with LVDD, patients with SMI and patients with type 2 diabetes, without LVDD and SMI). Methods. We investigated 104 type 2 diabetic patients (mean age 55.4±9.1 years, 64.4% males) with normal blood pressure, prehypertension and arterial hypertension stage I. Study design included basic laboratory assessment and cardiological workup (transthoracic echocardiography and tissue Doppler, as well as the exercise stress echocardiography). Results. LVDD was diagnosed in twelve patients (11.5%), while SMI was revealed in six patients (5.8%). Less patients with LVDD were using metformin, in comparison to other two groups (χ2 =12.152; p=0.002). Values of HDL cholesterol (F=4.515; p=0.013) and apolipoprotein A1 (F=5.128; p= 0.008) were significantly higher in patients with LVDD. Conclusion. The study confirmed asymptomatic cardiovascular complications in 17.3% patients with type 2 diabetes.

Keywords: type 2 diabetes mellitus, asymptomatic cardiovascular manifestations, left ventricular diastolic dysfunction, silent myocardial ischemia